(NEW YORK) — Store shelves at pharmacies across the county will soon be filled with affordable, quick, at-home coronavirus test kits.
BinaxNOW, a rapid COVID test made by Abbott Laboratories, was shipped Monday to major pharmaceutical chains, including Walgreens, CVS and Walmart, to be sold over the counter. The tests will be sold in two-count packs for $23.99.
The Food and Drug Administration gave an Emergency Use Authorization for BinaxNOW at the end of March. The test can be used on children as young as 2 when samples are collected by an adult and for all people 15 or older.
Users can take the test even if they don't show symptoms and get results within 15 minutes, according to Abbott.
The company says it will manufacture tens of millions of BinaxNOW Self Tests per month and can further scale capacity based on demand.
Abbott said they will work with retailers to prioritize distribution to areas of the country where the virus is surging as additional supply comes online.
"Over the past year, Abbott has developed high-quality rapid testing and invested in U.S. facilities to scale up manufacturing so we could bring affordable testing to Americans on a mass scale," Robert B. Ford, the president and CEO of Abbott said in a statement.
A spokesperson from Abbott told ABC News the company can produce tens of millions of kits a month. There are other over-the-counter rapid antigen tests available, like one from Ellume, out in the market.
Dr. Michael Mina, an assistant professor of epidemiology at Harvard T.H. Chan School of Public Health, said there will likely be a large demand for over-the-counter tests.
"At the moment, however, at 50 million per month split across over the counter and bulk sales to schools, businesses and other congregate settings, it is unclear what the availability of these tests will be over the coming weeks and months," Mina told ABC News.
He commended Abbott for indicating they will increase their supply based on the market demands.
"It is a major advance over what has been available," Mina said of BinaxNOW.
(WASHINGTON) — The U.S. is looking into additional cases of severe side effects possibly linked to the Johnson & Johnson vaccine, according to Centers for Disease Control and Prevention director Dr. Rochelle Walensky.
"These have been a handful of cases, not an overwhelming number of cases," Walensky said at a White House briefing on Monday. "We are working through and adjudicating them, and verifying whether they do, in fact, reflect a true case.”
The CDC and Food and Drug Administration called for a pause in the use of the Johnson & Johnson vaccine after six in nearly 7 million recipients reported severe adverse reactions, including blood clotting, once they received it.
Though Walensky insisted the number of possible new cases with serious reactions to the Johnson & Johnson vaccine aren't large, it is still unclear how many more there are in addition to the ones that have already been reported.
A decision to lift a suspension on the distribution of Johnson & Johnson vaccine could come as early as Friday when a CDC panel meets to discuss the findings.
"I believe we'll get back with it and there might be some restrictions," said Dr. Anthony Fauci on ABC's "This Week" Sunday. "Not sure what that will be, whether they'll be age or sex or whether they'll just come back with a warning of some sort."
The Biden administration and federal regulators argue that the suspension of administering the J&J vaccine shows that the health care system's infrastructure is working and shows that the oversight of the vaccine distribution is effective.
But the temporary pause of the Johnson & Johnson vaccine could also be raising questions among Americans who are already skeptical of taking any vaccine to begin with.
"We leave it up to you. Look at the data, the data speak for themselves," Fauci said. "We all want normalcy in America, the highway to that normalcy is vaccination.”
At this point, the Biden administration has also made it clear that it does not intend to divert vaccine supply away from states where vaccination numbers are still coming in low.
"We are not going to quote-unquote punish, less -- less-ready areas," said White House COVID-19 response coordinator Andy Slavitt. "We're going to actually work harder with them to make sure that people have the information they need.”
With all Americans 16-years-old and up now eligible to receive a COVID-19 vaccine, Fauci said that it's concerning to see certain portions of the American population still hesitant to take the vaccine.
"It's very disturbing that on the basis of political persuasion people are not wanting to get vaccinated," said Dr. Fauci on CBS This Morning. "Those are the ones that keep saying you're encroaching on our liberties by asking us to wear masks and to do the kinds of restrictions that are public health issues. The easiest way to get out of that is to get vaccinated."
(NEW YORK) -- All adults in the United States are eligible for COVID-19 vaccines starting Monday, with all 50 states and Washington, D.C., meeting the April 19 deadline President Joe Biden had set for opening eligibility.
Hawaii, Massachusetts, New Jersey, Rhode Island and Vermont were the last states to open eligibility to everyone age 16 and older on Monday. The April 19 deadline had been moved up from the May 1 goal Biden initially set for all adults to qualify for vaccination.
"No more confusing rules. No more confusing restrictions," Biden said earlier this month.
The increased eligibility comes as the one-shot Johnson & Johnson vaccine is on pause while a federal advisory committee evaluates a possible link to a rare but severe blood clotting disorder. According to Dr. Anthony Fauci, the nation's top infectious disease expert, the Johnson & Johnson suspension could be lifted by Friday.
Fauci told ABC's This Week that while he did not want to get ahead of federal regulators, he expects that when the pause lifts, experts will recommend a restriction or warning on the vaccine's use.
(NEW YORK) -- Some women are describing temporary changes in their menstrual cycles after taking a COVID-19 vaccine, experts in the medical community are reporting.
With nearly 30% of U.S. adults fully vaccinated, scientists and doctors still don't know why -- or even if -- vaccines might impact menstruation. However, they're listening to women's experiences, and calling for more studies to unpack any potential link. And, experts agree these changes are likely to be temporary, and there is no reason for women to worry about fertility.
"I personally experienced a period that was slightly longer and heavier after receiving my first COVID shot," said Dr. Nita Landry, a Los Angeles-based obstetrician and gynecologist.
"However, even having experienced it myself, I do realize that there can be a lot of potential causes for menstrual irregularities. Therefore, until we have well-designed studies that look into this matter, we can't make a definitive connection between the vaccine and menstrual irregularities," Landry added.
A possible explanation may have to do with how the body responds to physical and even emotional stresses. Prior studies indicate that COVID-19 itself can be one stressor, leading to irregular menstrual cycles for some people.
One study out of Tongji Hospital in China looked at menstrual cycles of 177 women who had COVID-19 infections. While the majority of women did not experience any changes, 20% of the women had lighter periods, and 18% had a delay in their periods.
"If you're severely ill, right, you're going to have menstrual changes, regardless of what the illness is." said Dr. Susan Loeb-Zeitlin, gynecologist at NewYork-Presbyterian and Weill Cornell Medicine. "You often, not always, but often, will have menstrual changes. So it is just the stress of an illness."
Menstrual changes are controlled by a part of the brain called the hypothalamus, along with the ovaries, which use hormones as signals. These delicate hormone signals can be disrupted when the body goes through changes that occur with an infection, and even a vaccine.
Dr. Jacques Moritz, OBGYN and medical director at Tia, likened the hypothalamus to a "metronome" which regulates menstrual cycles to "the precise micro-beat, that anything can throw off".
Moritz said that after the vaccine, he was not surprised that "there could be a change in menstrual either volume or delay in menstruation, or even having the period come sooner."
While symptoms may occur for some women during a menstrual cycle following the vaccine, experts say it's unlikely that these symptoms would persist for multiple cycles.
"What you'll see is, most times, that people will resort back to their normal cycle, because now there's no more changes to the hormonal timeline, outside of the vaccination," said Dr. Jessica Shepherd, OBGYN and chief medical officer at Verywell Health.
Menstrual cycle changes lasting "three months consecutively, or more" are when health care providers typically make investigation or treatment plans, said Shepherd.
"However, if by chance you're going through a pad an hour, and it's just an extreme change from what you typically experience, then I would say, notify a healthcare provider," added Landry.
While some women may experience temporary changes to their menstrual cycles, the experts say it's important to note that current evidence suggests that the vaccine has no impact on current or future fertility.
"It doesn't seem to have any impact on fertility," said Loeb-Zeitlin. "There's no biologic reason why it should impact pregnancy."
(NEW YORK) -- Half of Americans over 18 have received at least one COVID-19 vaccination shot, according to data released Sunday by the Centers for Disease Control and Prevention.
There were close to 130 million adults in the country who received one shot, roughly 50.4% of the over-18 population, the agency reported.
At least 83.9 million adults, roughly 32.5% of the adult population, was fully vaccinated as of Sunday, the CDC said.
The data comes as more states open up their eligibility to all residents above 16.
It also comes as states pause their administrations of the one-shot Johnson & Johnson vaccine, which is being researched by the Food and Drug Administration and CDC over rare reports of possible blood clots.
As of Sunday, over 209 million vaccine doses have been administered in the country, CDC data shows. At least 109 million Pfizer doses have been administered, 92 million Moderna doses and 7.9 million Johnson & Johnson doses, according to the CDC.
Health officials and leaders are encouraging all eligible Americans to schedule their shots as soon as possible, to decrease the number of cases and curb the spread of the virus.
(NEW YORK) -- Regina Townsend, 39, of Chicago, said that as a Black child and then as a young Black woman, she never heard discussions of infertility and in vitro fertilization among her family and friends.
When she had difficulty getting pregnant after getting married, Townsend said she looked online and did not see any information about or representation of women who looked like her.
"I started to get angry, and I started just talking about it, because I needed to get it out," Townsend told ABC News' Good Morning America. "I started the blog, and I started talking about it on my Facebook, just like this is happening, and I started getting comments like, ‘Thank you for talking about this.’"
"It’s not that we didn’t experience it. It’s just that no one talked about it," she said.
Black women who have never given birth are almost twice as likely than white women to experience infertility, but they seek medical help for it half as much, according to data from the U.S. Centers for Disease Control and Prevention (CDC). Around 15% of white women between ages 25 and 44 seek infertility treatment, compared with 8% of Black women, according to the data, released in 2014.
Townsend started a website, TheBrokenBrownEgg.com, where she talked about her own infertility journey and later began offering resources to help other Black women.
In doing so, she became one of the early founders of a movement to make the topics of infertility and infertility treatments more accessible to Black women.
"The biggest message for Black women that I want them to know is that you are allowed to make decisions about your life," said Townsend, who gave birth to a son in 2016 after undergoing IVF. "It’s OK to want kids. It’s OK to not want kids. It’s OK to ask for a second opinion. It’s OK to tell your family that you’re going to do something no one in your family has done, like adopt or use IVF or a surrogate."
Here are four organizations, including Townsend's, working to empower Black women to take charge of their fertility journeys:
1. Fertility for Colored Girls
Rev. Dr. Stacey L. Edwards-Dunn founded Fertility for Colored Girls after experiencing infertility herself.
"When I was on my journey of infertility, I wanted to be able to talk to other women who looked like me, who I thought would understand what I was going through," she told GMA in 2019. "I want other women and men to know that they are not alone."
Edwards-Dunn's organization offers grants to help people cover the costs of infertility treatments and also offers private support groups, individual and couples' counseling and educational programs and events across the country.
2. The Broken Brown Egg
Townsend said her mission with The Broken Brown Egg is to encourage Black women to begin the "very important dialogue of reproductive health and fertility."
The organization offers online support groups as well as a resources guide and Townsend's blog, where people can read and relate to her nearly 10-year journey to becoming a mom.
3. Black Mamas Matter Alliance
The Black Mamas Matter Alliance is a Black women-led organization that launched in 2016 to help address Black maternal health inequity and improve Black maternal health outcomes, according to its website.
The organization holds an annual conference for stakeholders working to improve maternal health equity, as well as regional summits around the country. It also provides technical assistance and trainings for maternity care service providers, like midwives, doulas and community health workers, and advocates for legislative policies to help Black women.
4. The Cade Foundation
The Tinina Q. Cade Foundation is a nonprofit organization that offers grants to help people cover the costs of becoming a parent.
The Family Building Grant, for example, provides "up to $10,000 per funded family to help with costs of domestic adoption and medical fertility treatment," according to the website.
The organization, launched in 2005 by Dr. Jason Hammond and Dr. Camille Hammond, a couple who struggled with infertility, also provides resources to help people find other available grants.
(JACKSON, Miss.) -- When winter storms swept throughout the South in mid-February, millions of people lost power and water for days. One of the cities hit hardest was Jackson, Mississippi.
The capital city of Mississippi went without clean water for nearly a month. Some Jackson residents who spoke with ABC News said they have had no running water in their homes for up to three weeks.
This is not the first time there has been a water problem in Jackson. Aging infrastructure of the city’s water pipes, changes in weather patterns and lack of resources, have contributed to inconsistent access to clean water for decades.
“They said … you experienced the water crisis recently. I would actually argue that we're still in the midst of a water crisis,” Jackson Mayor Chokwe Antar Lumumba said. “It’s not a matter of, if it's a matter of when it will fail again, until we get the adequate resources to address it.”
After the storms, Lumumba submitted a $47 million proposal to the state to receive funding to repair infrastructure. In 2014, the citizens of Jackson also voted to enforce a 1% sales tax to provide more money for infrastructure, which Lumumba says brings in around $13 million a year.
However, Lumumba told ABC News, "this is just a starting point." He said repairing all of Jackson’s infrastructure would cost nearly $2 billion.
President Joe Biden addressed the nation’s infrastructure needs and proposed a “once-in-a-generation” $2 trillion infrastructure plan that would fix several looming infrastructure issues across the country. Among them would be replacing all lead pipes carrying drinking water.
"I'm convinced that if we act now, in 50 years, people are going to look back and say, 'This was the moment that America won the future,’” Biden said.
Jackson has an over 82% Black population, according to the U.S. Census Bureau. Lumumba said environmental racism, divestment and white flight all play a part in the city's infrastructure crisis.
“I think that you find less willingness from the state to support a city like Jackson, because they don't necessarily feel that the demographics of Jackson, or even the politics of Jackson resemble the majority opinion,” Lumumba said. “We have to understand that these aren't Democratic or Republican issues. These are our human issues.”
Four citizens of Jackson spoke with ABC News's Good Morning America about the impact of the city's water crisis.
Coach Rod McKee
Rod McKee has been a teacher and football coach at Wingfield High School in south Jackson, Mississippi for four years. He said water problems not only impacted his students during this year’s winter storms -- but have impacted them every year he has taught in the school..
“All four years we’ve experienced kids having to be out of school due to a water outage caused by the school pipes bursting from being too old,” McKee said. “The school extends school hours from eight to four to make up hours and days in case we have a water crisis, which I feel like is unfair to the students.”
McKee said when the water goes out at school meals are replaced by sack lunches. With extended hours, students may have only having eaten one sack lunch, he said.
While there have been recurring problems throughout the years with water and education, the winter storm that swept Jackson, brought the most severe problems McKee said he has seen in the city.
“I had students that went a month without water,” McKee said. “On top of being home quarantined, and have to learn virtually, that's the last thing I want to do is put pressure on them about a class…It was a lot.”
McKee said the school hosted water drives that turned into food drives during this winter’s crisis. Many businesses around the area stepped up to deliver hot plates to people who couldn’t cook or wash their dishes, he said.
McKee said that he and his family had their own struggles. He had to place a trashcan in his driveway to catch ice so enough water would melt for his family to be able to flush their toilets, he told ABC News.
“It should’ve never gotten to this point. There’s enough resources. This is America,” McKee said.
Danyelle Holmes, a Jackson resident since 1991 and a national organizer with the Poor People’s Campaign, was on the ground helping out her fellow Jackson residents after the storm this winter.
Holmes told ABC News that her group focused on not only handing out clean water, but also giving a stipend to Jackson residents for the work they were doing in the community.
“We gave out over 100,000 cases of water over the state of Mississippi,” Holmes said. “Just in the city of Jackson we gave out close to $100,000. Our assistance is still going on.”
While this water crisis was amplified by the winter storm, Holmes said there have always been water issues in Jackson. In the 30 years she has lived in the city, she said she has never drunk water out of the tap.
“It’s always brown. Even at my home having brown water is normal,” Holmes said. “I’ve always relied on bottled or filtered water.”
Holmes said the water issues come from years of infrastructure issues in Jackson and she hopes the magnitude of the water outages caused by this year’s winter storm will bring light to the improvements the city needs.
“It took the negligence on our leadership on just not really investing into the capital. The very city they have to come to to handle their business has been neglected for years,” Holmes said. “This winter storm had to happen in order to expose … what's actually going on what's still going on in the state of Mississippi.”
Willie William has lived in Jackson, Mississippi, since 2000 and three years ago started his own local business -- a food truck called Scherria’s Chicken Coop.
During the water crisis, William was hired by World Central Kitchen to make hot plates for many in the community who didn’t have food. Each week for three weeks, William made 2,000 to 3,000 hot meals to deliver to people in the community.
William was more than happy to help, but after a year of dealing with the pandemic, the water crisis made business harder for him.
“It makes the work ten times harder. You have to boil the water when you’re doing everything,” William said. “I buy five-gallon water jugs to cook out because the water is still not safe. It makes it difficult for your customer base too because you have to change a lot of the menu items ... When the pandemic came the numbers for food weren’t up so we had to change the prices on our menu.”
While the water crisis impacted William as a small business owner, as a Jackson citizen water issues have become a part of life.
“There’s been numerous times the water has been low pressure or sometimes the rusted water," William said. “The water system is very old here. It needs to be replaced and that’s something that’s understood. But that’s going to take a lot of funding, something we probably don’t have in the budget.”
William hopes that this winter’s crisis and awareness of the problem inspires change, but until then, he said, the members of the Jackson community will each do their part to help.
“Jackson is a violent city right now but there’s a lot of people here that still care and just try to give back and do what we can,” William said. “We’re one tight-knit community.”
Pastor Arthur Sutton
Arthur Sutton, a pastor at Progressive M.B. Church, has lived in Jackson for 52 years. When the water ran dry after the winter storms on Feb. 16, he said he had never seen anything like that before.
“I have never seen it like this before,” Sutton said. “I was without water, no pressure, nothing for 17 days. When the water came back on we had to wait a minute because of the different types of debris and substances inside the water ..when you boiled your water the stuff was still there.”
As a pastor, Sutton wasn’t just worried for himself but for all the members of his church. When other Baptists churches across the country heard about the water crisis in Jackson, they began reaching out to Sutton to send his church water.
“We’ve probably given out close to 100 of more pallets of water. Most pallets come with 60 to 84 cases of water,” Sutton said. “That’s a lot of water.”
Sutton said many members of his church were elderly and unable to pick up water for themselves, so they set up a delivery service.
“It was bad, I’m going to be honest with you,” Sutton said. “It hurts when everybody else starts getting water and you’re the last to get water.”
Sutton says officials need to communicate and assure the citizens of Jackson that they will not have to deal with a crisis like this in the future.
“What they need to do is they need to get together and talk and communicate where this does not happen again,” Sutton says. “Whatever funding that we need, we need to get it and we can go ahead and repair our infrastructure…to where if something happens that these people can still get water.”
Government and the environment
The Environmental Protection Agency (EPA) says that while over 93% of Americans have water from community water systems that meet all health standards, there are improvements to be made.
“EPA understands that more work needs to be done so that everyone in the United States has access to safe water that meets EPA’s standards – no matter the color of their skin, money on their pocket, or zip code,” EPA Senior Public Affairs Specialist Cathy Milbourn said in a statement.
According to the EPA, over $743 billion is needed for water infrastructure improvements in the Untied States.
To date, EPA’s State Revolving Funds have provided more than $189 billion in assistance for nearly 43,000 water quality infrastructure projects and 16,500 drinking water projects. In the past two years, these State Revolving Funds have also created over 300,000 jobs.
President Biden has proposed a $2 trillion infrastructure overhaul, the American Jobs Plan. Part of the plan proposes eliminating “all lead pipes and service lines in our drinking water systems, improving the health of our country’s children and communities of color,” the plan states on the White House website.
Many Republicans have signaled they don’t support the proposal but Sen. Roger Wicker, R-Miss., said on ABC’s This Week that the GOP is willing to negotiate on a smaller package.
While cities like Jackson continue to fight for funding at both the state and federal levels, Jackson Mayor Lumumba encourages people who want to help their community to donate money to philanthropic causes set up to help with the water crisis.
“In the midst of people being without running water in their homes we had a number of good Samaritans from not only across the city but across the country,” Lumumba said.
Lumumba hopes that an awareness of the issue in Jackson will bring about the changes necessary to build a more sustainable water system.
“We need to continue to lift up the need for infrastructure. At this point, what is the success and failure of our economy?” Lumumba said. “It needs to be less about the stock market and more about sustainable development goals, whether people have access to sustainable infrastructure. Those are the metrics we need to evaluate this nation.”
(NEW YORK) -- With the Johnson & Johnson COVID-19 vaccine still on pause in the U.S. after reports of a rare but severe blood clotting disorder in a small number of the roughly 7 million people who've received the shot, health experts now are focusing on what could be behind those uncommon adverse events.
Doctors, scientists and public health experts are turning to Europe for clues, where a similar vaccine made by AstraZeneca -- not yet authorized in the U.S. -- also has been linked to a number of rare blood clots.
"The AstraZeneca and Johnson & Johnson vaccines are made in a similar way," said Dr. William Schaffner, an infectious disease physician at Vanderbilt University with expertise in preventive medicine and health policy. "But the carriers are different kinds of adenoviruses ... that's part of the background information, why indeed there is a pause now."
"It's hard to say if it's the same problem," said Dr. Richard Kuhn, Ph.D., a virology expert at Purdue University, "but it does seem the vaccine triggers an antibody response that activates platelets, leading to clots."
While many experts have hesitated to say for sure if there is a link, Schaffner said there's a growing consensus in the scientific community after none of these rare clots have been linked to the Pfizer or Moderna vaccines, which use mRNA, a different technology.
"I think we shouldn't be coy about that any longer," Schaffner said, adding that it may be time to "accept the fact that these are vaccine-induced but very rare events."
But experts cautioned that even if there is a link, current evidence suggests the risk of developing a blood clot after getting the Johnson & Johnson vaccine is exceedingly low -- lower, in fact, than being struck by lightning.
Responding to a report on one of the six clot cases published in the New England Journal of Medicine, Johnson & Johnson penned a response Friday, insisting a clear link has not yet been established.
"At this time, evidence is insufficient to establish a causal relationship between these events and the [Johnson & Johnson] vaccine," Janssen scientists said, adding that the vectors used in their vaccine and AstraZeneca's are "substantially different" and that those differences could lead to "quite different biological effects." The researchers added that "more evidence is needed" to further clarify the cause of this clotting, combined with low platelet count in those receiving the COVID-19 vaccine.
Next week, the Centers for Disease Control and Prevention's independent advisory committee will review all evidence and make a recommendation about whether to resume using J&J vaccines.
Still with more questions than answers, scientists are exploring different theories about why this type of shot -- called a viral vector vaccine -- might cause rare clotting problems.
Vaccines work by prompting our immune systems to develop antibodies against a virus, and a prevailing theory is that viral vector vaccines somehow trigger an abnormal immune response, leading to the blood clots.
Scientists in Germany identified a specific antibody in many people who developed clots after receiving the AstraZeneca vaccine -- and U.S. researchers subsequently identified the same antibody in individuals who developed similar clots after getting a J&J vaccine. In these subjects, the body's immune system has formed antibodies that attach to platelets, the specialized blood cells that join together to form clots.
"It's not the vaccine that's causing it -- it's the body's immune response to the vaccine," said Dr. Alex Spyropoulos, a blood clot specialist and professor at the Feinstein Institutes for Medical Research. Experts say the condition, cerebral venous sinus thrombosis, or CVST, is exceedingly rare.
The Food and Drug Administration and CDC said that in the six women who experienced a clot, the problem manifested six to 13 days after receiving the shot, a time frame that tracks with an immune response, Spyropoulos said.
It's still not clear why a vaccine would trigger this cascade of events, but researchers said it mimics another well-documented reaction to heparin, a common blood thinner. For this reason, the CDC and FDA have warned against using heparin to treat anyone recently vaccinated with the Johnson & Johnson vaccine.
Existing evidence from the United States and Europe hints that women may be at greater risk – perhaps in part because women are already more likely than men to develop CVST, based on previous data.
"We have to be careful about the assumptions we make," Spryopoulos cautioned, "especially given how infrequent these events have been."
It's possible similar cases will develop in men, but if the CDC advisory panel concludes that the risk is higher in women, the FDA could move toward a black box warning -- a label for drugs and medical devices with potentially serious side effects – on the Johnson & Johnson vaccine for certain women.
Though the abrupt halt to an already authorized vaccine may instill concerns and foment hesitancy around the vaccine, experts said it's a good sign drugs are being properly vetted for safety.
"I really want to stress to the public that they need to remain confident in our concepts and the times regarding vaccines in general," said Dr. Jason Goldman, an internal medicine doctor representing the American College of Physicians on the expert panel said, adding that members of the general public should "not to let this sour your decision on getting vaccinated in general."
"We do have confidence in the process," Goldman added. "And we will make the right decision regarding public safety."
Amanda Benarroch, M.D., a psychiatry resident at Mayo Clinic in Rochester, Minnesota, is a contributor to the ABC News Medical Unit. ABC News' Sasha Pezenik and Sony Salzman contributed to this report.
(NEW YORK) -- COVID-19 has taken the lives of more than 565,000 Americans and counting.
Those we've lost come from all backgrounds and include the very people -- first responders and medical staff -- who have been working on the front lines. But the virus has also highlighted the disparities in the U.S. -- taking a disproportionate toll on communities of color, the elderly and the poor.
Each week ABC News is spotlighting several Americans who have lost their lives to COVID-19. This week, we're highlighting a Georgia county commissioner, a devoted Alabama dad and a dedicated Philadelphia police officer.
Henry County, Georgia, Commissioner Gary Barham, who held the position in his home county since 2013, died on March 2, The Atlanta Journal Constitution reported.
Henry County spokeswoman Melissa Robinson said, "Gary was a servant leader who cared deeply for Henry County and worked across the aisle and all lines for the betterment of Henry County and its citizens. Gary was a true gentleman and the voice of reason for so many. We are all better for having known him, and he will be deeply missed."
Fellow district commissioner Dee Clemmons told ABC News, "Gary Barham fought to the end, through his battle with COVID, with unwavering love and service to this community he called his hometown and his desire for unity will remain as my guide. That’s how I will remember my colleague and friend."
Barham is survived by his wife of 34 years, two sons and five grandchildren, The Atlanta Journal Constitution said.
Alfonzia Jackson, a father of two girls ages 4 and 6, died on Feb. 2, 2021, The Miami Herald reported.
The 35-year-old Birmingham man also leaves behind his wife of seven years, the Herald said.
Jackson loved to dance with his daughters and paint their nails, the Herald reported.
His wife, Ashley Jackson, wrote on Facebook, "Our girls are going to truly miss you, you were an amazing dad and I will keep your memory alive through them and they will always remember you."
Erin Tokley, 47, was a 24-year veteran of the Philadelphia Police Department.
Tokley, who was also a minister at a Philadelphia church, died on March 3, 2021, ABC Philadelphia station WPVI reported.
"Our department has a heavy heart," tweeted Inspector Verdell Johnson, the commanding officer of training and education.
"His final message to me was, 'I'm gonna keep fighting until I come home,'" said his wife, Octavia, according to WPVI.
(NEW YORK) -- When Kristi Escobar was offered an appointment to get the Johnson & Johnson vaccine last Monday, she wondered if she should wait for another option.
J&J was the newest of the three vaccines available. And there had been a recent report of contamination issues at a supply plant in Baltimore that prevented the company from shipping doses using that facility.
But Escobar, a 38-year-old teacher at a community college who had tested positive for COVID-19 in January, knew that aggressive new variants of the virus still posed a threat, and that health experts recommended that people with prior infections still get the vaccine.
"I trusted in what they said as far as, 'Take the vaccine you can get,'" she said.
On Tuesday, the day following her shot, Escobar was stunned to learn that federal regulators had recommended a nationwide suspension of all J&J injections following reports of rare, but serious blood clots.
The cases were extraordinarily rare -- 6 out of nearly 7 million people who had gotten the vaccine suffered blood clots in the brain and low platelets. A person is twice as likely to get hit by lightning than to have such a serious a reaction to the J&J vaccine. What's more is that blood clotting can be a serious complication of COVID-19 too, which has already killed more than 566,000 Americans.
In fact, the complications were so limited that several governors and health experts heatedly criticized the decision to continue a "pause" in injections, arguing it could put even more lives at risk due to COVID.
Still, the reports of complications felt personal to Escobar, and many other women who recently received J&J shots. Each of the six cases in the U.S. were women of childbearing age, between 18 and 48. One of the women, a 45-year-old, also from Virginia, died.
Escobar said she immediately began to cry when she heard the news.
"My fear is probably not rationale," she said. "But I can't help it. It's just how I feel."
Escobar is now among the estimated 3 million Americans who got the J&J vaccine recently enough that the Centers for Disease Control and Prevention are urging them to be on the lookout for severe headaches, chest or leg pain or difficulty breathing.
Timing of a person's symptoms matter. Among the six cases under investigation, the symptoms emerged six to 18 days following the injection.
People who got the J&J shot more than three weeks ago are not considered at risk, and experts say it's normal to experience mild flu-like symptoms in the 24-48 hours following a vaccine. The rare blood clotting has not been associated with the Moderna or Pfizer vaccines.
Angie Willson, a 45-year-old mom and nurse anesthetist in Detroit, said she relates to the anxiety. Willson had purposefully sought out the J&J vaccine, believing it was a "more traditional choice" among the COVID vaccines and driving an hour-and-a-half out of state to get it almost two weeks before the nationwide suspension.
As a health care worker, Willson could have gotten vaccinated sooner, but didn't pull the trigger until the recent surge in COVID-19 cases flooded her Michigan hospital with younger patients whose lungs were ravaged by the virus.
Now, she said, her feelings are mixed.
"I'm glad I'm building antibodies, but I'm sweating it. ... It's very emotional," Willson said.
With the nationwide suspension in place, regulators are now watching to see if more cases might emerge in the coming days that will help solve what has become a frustrating medical mystery: Is the J&J vaccine to blame for these very rare, but very serious blood clots? Are young, healthy women most at risk? Is this type of vaccine still safe for other people?
One primary concern is how health care providers can treat any complications, even if they are rare. So far, officials say doctors should avoid heparin in these cases because the blood thinner appeared to make the complications worse.
In a statement, J&J said it believes "in the positive benefit-risk profile of our vaccine." But the company also agreed to delay its rollout of the vaccine in Europe and pause its clinical trials until more data comes in.
"The safety and well-being of the people who use our products is our number one priority, and we strongly support awareness of the signs and symptoms of this extremely rare event to ensure the correct diagnosis, appropriate treatment and expedited reporting by health care professionals," Paul Stoffels, a vice chairman and chief scientific officer at J&J, said in a statement.
Top government officials insisted this week that they expected the matter to resolved in a matter of "days." But answers don't seem to be coming any time soon.
An independent government advisory panel decided on Wednesday that it needs more data before it can recommend a next step. The panel's next meeting is scheduled for April 23, and will be livestreamed to the public.
"We want this to be a pause long enough to get the answer to come to a conclusion that is reasonably, scientifically based. But not long enough so that we can erode confidence in this vaccine," said Dr. Jose Romero, who chairs the panel, which advises the CDC.
In the meantime, Escobar said she is searching the internet several times a day in the hopes that there is an update. She also is marking the days on her calendar until she gets past the estimated 18 days after her shot when experts say her risk level of complications will drop.
"I've calmed down since Tuesday, for sure," she said. "But I am wishing these days go faster."
Willson estimates she only has a couple more days until she is in the clear.
(ANN ARBOR, Mich.) -- As COVID-19 vaccines have rolled out and the world begins to slowly reopen, a Michigan mother is encouraging others to continue living with caution as her child fights the virus.
"This is serious and it's killing people," Andrea Bell told Good Morning America. "Maybe you're not at risk, but I sure bet someone you love is."
"I never thought in a million years that I'd be sitting here," she added. "I never thought we'd have to experience COVID this closely, but I was wrong. I think people are tired and they're craving normalcy, but there's nothing normal about your child on ECMO."
ECMO stands for extracorporeal membrane oxygenation -- a treatment in which blood is pumped out of the body to a machine that removes carbon dioxide and sends oxygen-filled blood back to tissues in the body. It’s used to help the heart and lungs heal, according to Mayo Clinic.
Bell, of Ann Arbor, is currently in isolation with her daughter Fiona. The 1-year-old is being treated at University of Michigan's CS Mott Children's Hospital. Fiona is breathing on a ventilator, sedated and is on ECMO.
Fiona was diagnosed with spina bifida in utero and hydrocephalus -- a condition which causes a buildup of fluid in the brain. Fiona had a surgical procedure where a shunt was placed in her brain to release the fluid and pressure.
Fiona also had a tracheostomy last summer. Bell said that because of Fiona's medically-fragile airway, she and her husband Kirk had their "home in lockdown" since the start of the pandemic.
"The severity of what's happened to Fiona is not because of her spina bifida, it's because COVID basically ate through her right lung and that's what put her on ECMO," Bell said. "It's more so related to the tracheostomy. Any kid that has a trach is at a higher risk for respiratory things."
On April 2, doctors suggested she bring Fiona to the emergency room for evaluations after she struggled with respiratory care. Hours later, Fiona spiked a fever and was having trouble breathing. She then tested positive for COVID-19.
Bell said she's not certain how Fiona contracted the virus, though said she had been to her rehab clinic and hospital for therapies.
Kristen Padilla is Fiona's pediatrician at Mott Children's. Padilla said Fiona has been a "fighter her entire life" and has undergone multiple surgeries before she turned 1.
"She’s a remarkable little girl who always greets you with a smile and her family has played it incredibly safe throughout the pandemic," Padilla told GMA. "We discussed that a COVID-19 illness could be serious, however, we never expected this."
She added, "In Fiona’s case, the only thing that could have been done differently was to make sure every person she ever came into contact with was vaccinated. It is my hope that people will see this beautiful toddler and realize that their actions can affect others. Receiving a COVID-19 vaccine and following pandemic precautions are the only ways to protect our most vulnerable, like Fiona."
In March, Pfizer and BioNTech announced that their COVID-19 vaccine is 100% effective against the virus in children ages 12 to 15.
They also launched a global COVID-19 vaccine trial that will ultimately enroll 4,500 children between the ages of 6 months and 11 years old.
Their vaccine is currently authorized -- under the federal drug administration’s emergency use authorization -- to be distributed in the U.S. for use in people ages 16 and up.
Earlier this month, CDC director Dr. Rochelle Walensky told ABC News chief medical correspondent Dr. Jennifer Ashton that kids 12 and up might be able to get the vaccine starting "mid-May," pending Food and Drug Administration authorization for that age group.
Younger children will come later.
Bell said Fiona will receive the vaccine once it becomes available and her doctors give the go-ahead.
Fiona is in stable condition. Her chest X-rays have improved, and as of Thursday, she was able to sustain her breath on the ventilator, Bell said, adding that she's confident she will be bringing Fiona home soon.
"What's really incredible about Fiona is she will wake up from brain surgery and be smiling," Bell said. "She's so feisty and sweet ... it sounds like a cliche, but she lights up the room."
As Fiona continues to fight, the Bell family has been receiving cards, picture books and artwork from kids around the world, which Bell hangs in Fiona's hospital room. Bell said Fiona's favorite color is yellow.
Mail can be sent to: C.S. Mott Children’s Hospital, Attn: Fiona Bell Pediatric Intensive Care Unit 10 East 1540 East Hospital Drive Ann Arbor, Michigan 48109.
Bell said she encourages people to continue wearing masks. She hopes Fiona's story inspires others to get the vaccine, she added.
(NEW YORK) -- The Johnson & Johnson vaccine pause, likely to last another seven to 10 days while a federal advisory committee evaluates a possible link to a rare but severe blood clotting disorder, may deal a blow to vulnerable populations -- the homebound, homeless and incarcerated among them -- because it had been easier to get those individuals one shot than two, health experts said.
In addition to being a single dose, the J&J vaccine "is easier to store than the two mRNA vaccines that require freezing," said Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University. "That adds to the complexity of trying to set up vaccinations in settings that are not clinical."
"The reality is, not every site is equipped to to handle the mRNA vaccines," added Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News contributor. "J&J is a really important vaccine for those who are most vulnerable to the consequences of this virus."
"That's the concern I have," he added. "There's going to be barriers to access that come from this pause."
At George W. Hill Correctional Facility in Pennsylvania, a for-profit facility run by the GEO Group, Thursday was supposed to be vaccine day. A mass vaccination event had been scheduled for the roughly 1,300 people incarcerated there -- all were to be offered a Johnson & Johnson shot. Tuesday's pause to examine the vaccine more closely put those plans on hold indefinitely.
"We certainly hope that that the pause is a temporary one," Kevin Madden, chair of the jail oversight board and a Delaware County council member, told ABC News. "If that pause lasts too long, then perhaps we can revisit the conversation with GEO about moving to an alternative vaccination."
Compared to a state prison, George W. Hill's population is more transient. A sizable portion of those incarcerated likely will leave the facility in the next 25 days, making Johnson & Johnson shots a better option, Madden explained.
The two-dose vaccines "create a logistical challenge," he said. "Not not an insurmountable one, but one you've got to work through to schedule a second shot."
The delay comes after a year in which prisons have been the site of repeated COVID-19 outbreaks -- since March 2020, at least 392,595 people in prison have been infected and 2,515 have died, according to The Marshall Project, which is tracking prison data from all 50 states and from the Federal Bureau of Prisons.
Ninety of the 100 largest COVID-19 clusters occurred in prisons and jails as of August 2020, according to the COVID Prison Project.
Many prisons are chronically overcrowded, dormitory settings with shared toilets and showers.
"Social distancing is impossible," said Claire Shubik-Richards, executive director of the Pennsylvania prison society, a nonprofit prison advocacy group. "All the mask-wearing and hand-washing in the world will not keep the virus from spreading in a congregate care setting like a prison."
But despite those factors, many states have been slow to vaccinate incarcerated populations, in part because it's not a politically sympathetic group, Shubik-Richards explained.
While there's no official tracking system for vaccinations in correctional settings, 137,064 people in state or federal prisons had received at least one dose of the COVID-19 vaccine as of April 1, out of roughly 2.2 million incarcerated people nationwide, according to an article published in the journal Health Affairs, which used COVID Prison Project data.
Before the Johnson & Johnson pause, in Pennsylvania "very few county facilities had even begun to start vaccinating incarcerated people," Shubik-Richards said. The pause may push that timeline back even further, she added, and that delay could have serious consequences.
"Prison outbreaks are going to be one of the handful of events that will prolong or deepen this fourth wave," Shubik-Richards said.
'Prisoners are keenly aware'
While Dr. Anthony Fauci has said that the Johnson & Johnson pause should be viewed as a "testimony to how seriously we take safety," some experts are worried that the pause could lead to increased vaccine hesitancy, particularly in vulnerable populations that might be less likely to trust medical institutions in the first place.
"Vaccine confidence tends to be lower amongst people who have been disenfranchised," El-Sadr, said.
Among incarcerated people, that hesitancy may be tied to a historical legacy of doctors experimenting on people in prison.
Shubik-Richards pointed to the infamous Holmesburg Prison experiments, during which a Philadelphia dermatologist tested skin and beauty products, as well as more dangerous drugs, like the herbicide dioxin, on people in prison.
"It's not ancient history," Shubik-Richards said of the prison experiments, some of which lasted well into the 1970s.
At George W. Hill Correctional Facility, Madden said that because they haven't been able to offer shots yet, hesitancy hadn't been a problem. At neighboring county jails, Madden said, the issue had come up.
"We're preparing for that," he said.
Despite legitimate reasons for incarcerated people to be skeptical about new medical treatments, "I think prisoners are keenly aware of how devastating COVID-19 has been on prison populations," El-Sadr said. "It's a very fine balance."
She also said she hoped that the pause wouldn't dissuade policymakers from expending every effort to vaccinate prison populations.
"The other vaccines that we have at our fingertips may be more complicated," she said, "but it's worth the effort."
(NEW YORK) -- Shaina Oliver's asthma flares up on cold days. Her kids can't play outside, often due to the heavy air pollution surrounding their community.
"It becomes a burden because you have to buy more air filters for each room," she said. "And it's not really possible for everybody to do air filters in every room."
Oliver, a field organizer for Moms Clean Air Force, lives in north Denver, which at one point was one of the most polluted zip codes in the U.S. The Suncor refinery, located just north of where she lives, is located in a predominantly Black and brown community. But if you head to the south side of Denver, she said, there are no homes near refineries.
"I think dealing with asthma is a form of environmental violence and racism on our people because we're the ones being impacted with the air pollution," she said. "We're the ones being segregated into these sacrifice zones."
Dr. Myrriah Gómez, an assistant professor at the University of New Mexico, said to understand environmental racism, it's important to understand precedent.
"European colonization, European colonialism, settler colonialism," she told ABC News' Good Morning America. "European settler colonialism was the first environmental trauma to the Indigenous peoples of the current United States."
Gómez researches environmental justice and environmental racism, inspired by her family history when the Manhattan Project -- government research studying nuclear weapons -- took place in Los Alamos, New Mexico, a community where the Tewa Pueblo people and Hispanic homesteaders resided.
According to Gómez, among many injustices that occurred when the project entered the state, her own great-grandparents were dispossessed of their ranch in the 1940s.
Because the lab needed workers, her grandfather worked cleaning tools that were used in experiments. Her family associated his exposure to harmful materials with his cancer diagnosis and death.
Similarly, Oliver, who is a member of the Navajo Nation in Shiprock, New Mexico, said her family has been impacted for generations by environmental racism from the Indian Removal Act of 1830 to the Indian Relocation Act of 1956.
Her grandfather, who relocated to Denver and then returned to the reservation in order to maintain ownership of their land, was one of many Navajo workers who worked in a coal plant on the reservation as well as in uranium mines before protective gear was administered. He later died of leukemia.
"When you are trying to get people to understand environmental racism, you have to have a conversation of how race exists in the United States and other places in the world," Gómez added.
History of environmental racism
In 1982, environmental justice sparked national attention when state government officials decided to dump loads of soil contaminated with toxic PCBs at a landfill in Afton, North Carolina, a predominantly African American community.
"It was utter disregard for the health and safety of the community where the landfill was sited," Dr. Benjamin Chavis Jr. told GMA.
Chavis was one of many activists who protested the state's decision to unload the waste. Once demonstrations began, Chavis said he received calls from people all over the country who detailed similar experiences happening to Native American, Latino, Black and Asian and Pacific Islander communities.
After weeks of demonstrating, the state still moved forward with dumping the waste in Afton. It was during this period of time that Chavis coined the term "environmental racism."
"When I first coined the term, environmental racism, it was racial discrimination and environmental policy, and environmental actions because these communities are being triaged," he said.
A national study, "Toxic Waste and Race," co-authored by Chavis in 1987 concluded race was a factor in deciding where to build waste facilities.
Chavis said incidents of leukemia and cancer increased after the Afton community was exposed to the pollutants from the toxic waste.
"So this delivery wasn't by accident, that these types of waste facilities were being put in these minority communities, racial and ethnic communities. It was deliberate," he said.
The disproportionate impact of COVID-19 on Black and brown communities exposed more background information about preexisting health conditions within minority groups.
A 2020 National Urban League study, "State of Black America," said the Black American community is three times more likely to get COVID-19 than white Americans, indicating that Black Americans were more susceptible to the virus due to their preexisting conditions.
"So the question is, what causes and what has caused and what tends to cause these preexisting conditions like asthma, and multiple forms of cancer, and it's directly related to the air we breathe, to the water we drInk and to the food we eat and to where we live," he said.
"A lot of places where the residences are in communities are over-exposed to pollutants and to toxins," he added.
Environmental racism today
Gómez added the importance of reminding students in her class that these acts are still happening.
"And by still happening, I mean, like, even the things that happened 100 years ago are still not rectified in terms of environmental hazards in their own communities," Gómez said.
According to a 2018 report by the Environmental Protection Agency, people of color are more likely to be impacted by particulate matter than white Americans, which can contribute to more health conditions.
While some examples of environmental racism have reached national attention, such as the water crisis in Flint, Michigan, and toxic locations like "Cancer Alley" along the Mississippi River, Gómez said there are many cases at the local level that also require attention.
"Environmental racism includes excluding people of color from decision-making processes," she said. "So if you don't have people of color being represented at the table, so to speak, in these decision-making places, [then] nobody is looking out in the best interests of those people."
Seeing Rep. Deb Haaland, U.S. secretary of the interior, make history as the first Native American appointed as a cabinet secretary was a significant moment for Gómez, adding that her appointment meant Indigenous lands and communities were finally going to be at the table.
For Oliver, pushing for change means listening to Gómez's advice and taking a look back.
"I think addressing those racist agendas that we consider laws, policies, treaties, regulations; those are [the places] where I would like to see political leaders really address," Oliver said.
(NEW YORK) -- When the pandemic hit more than a year ago, rates of depression soared, with 28% of respondents in one survey reporting depressive symptoms compared with 9% before COVID-19.
As levels of depression rise, public health experts typically expect suicide rates to follow. But two new studies show deaths by suicide possibly declined during the pandemic's early months.
After one study, published in JAMA, found that suicide rates declined in the United States from 2019 to 2020, a second study, published in Lancet Psychiatry and which included data from 21 different countries, suggested that suicide numbers were unchanged or lower in the pandemic's early months.
However, experts said, these two studies don't paint a complete picture.
"It's too early to know what the impact of COVID on suicide will be," said Dr. Panagiota Korenis, M.D., a forensic psychiatrist at the BronxCare Health System.
Korenis suspects that there will be a delay before we can fully appreciate the mental health impact of COVID-19.
The first study, for example, relies on provisional data. However, Robert Anderson, Ph.D., chief of the Mortality Statistics Branch at the Centers for Disease Control and Prevention, said he does expect suicide rates for those dates "will remain a decline" after a fuller analysis is completed.
"Because they typically require a death investigation, [reported] suicides are more likely to be delayed relative to other leading causes of death," said Anderson, adding that because death investigations may be delayed, especially during a pandemic, some causes of death are harder to count, such as overdoses. "We don't know what's behind an overdose -- if it's accidental or suicide."
The Lancet paper's authors suggest that some decrease in suicides in the early months of the pandemic could be attributable to the success of government and public mental health interventions as well as acts of solidarity in the community.
"The government helping people financially, people doing good things, heroic things, helping elderly neighbors" all may have been positive things that helped provide stability, Korenis said.
But, experts said, suicide rates could worsen the longer COVID-19 lingers.
"In some instances, COVID did inspire the best in us," Korenis added, "but for many people, these moments have fizzled into burnout and emotional fatigue."
Psychiatric research shows that there are several factors that may increase someone's risk of dying by suicide, such as having a mental illness like depression, financial hardship, having easy access to lethal means -- especially guns -- and a lack of protective factors like stable employment or solid relationships.
The pandemic saw many people lose jobs and struggle to maintain relationships, which could prove worrisome, experts said.
"It is hard to know why suicides have declined as mental health and economic problems have been on the rise," Anderson said.
Even with potentially promising data for the pandemic's early months, as rates of depression, anxiety disorders and other mental illnesses rise, many still are experiencing an increased risk overall of suicide.
"We are seeing an uptick in depression, an uptick in anxiety, an uptick in psychotic disorders," Korenis explained, "and how we do managing those patients will determine how COVID impacts our suicide rates once the pandemic is over."
If you or a loved one is experiencing suicidal thoughts, The National Suicide Prevention Lifeline provides 24/7, free and confidential support. Call 1-800-273-8255 for help.
(NEW YORK) -- Dr. Sharon Ingram, a board-certified OBGYN in Florida, was in medical school when her four-month-old son, Alton Jr., died of sudden infant death syndrome (SIDS) while at a day care center.
"I dropped out of medical school because I thought that I should have been not studying," Ingram told ABC News' Good Morning America about losing her first-born child nearly 20 years ago. "I thought I should have been with him because maybe I could have made a difference, although I know now that you cannot."
The death of Alton Jr., who was called A.J., was considered a case of infant mortality because he died before his first birthday. On average, around 20,000 infants die in the United States each year, according to the U.S. Centers for Disease Control and Prevention (CDC).
It was only after her son's death that Ingram realized she had a major risk factor for infant mortality simply by being a Black woman.
"A.J. wasn’t sleeping on his belly, I had prenatal care, he wasn’t low birth rate, but there were still some risk factors that we overlooked," she said. "One, I was Black, two, I had a son, and, three, he passed away in December, in a cold climate."
Ingram, who ultimately returned to medical school and chose to become an OBGYN, said she remembers being surprised when she saw her race listed as a risk factor for infant death.
"I was totally shocked," she said. "I remember thinking, ‘Why is that?’"
Nearly 20 years after A.J.'s death, Black babies still have a higher chance of dying than white infants, data shows.
Babies born to Black women in the U.S. have two times the infant mortality rate of babies born to non-Hispanic white women, according to the Department of Health and Human Services' Office of Minority Health.
Black babies are also nearly four times as likely to die from complications related to low birthweight and have over twice the SIDS mortality rate as non-Hispanic whites, according to the Office on Minority Health.
"If we look at the last five years, we are doing a good job at decreasing the infant mortality rate in general but the gap [between Black and white babies] is still there, so though the overall rate is going down, the gap is still double," Ingram said. "It makes you step back and say, ‘Why is this happening?’"
Implicit bias and Black infant deaths
Ingram and other experts point to implicit bias and institutional racism in medicine as two of the reasons for the disproportionate number of Black infants dying in the U.S.
And they say the higher rate of Black infant deaths can be traced back to the medical care Black women receive during pregnancy.
"Looking at racial disparities in general, when we look at babies, it really starts with the mom," Ingram said. "There is a discrepancy in care for Black women and that is why we have premature birth rates and see so many pregnancy complications that can result in infant death."
Black women in the U.S. -- which continues to have the highest rate of maternal mortality among developed nations -- are more than twice as likely to die during childbirth or in the months after than white, Asian or Latina women, according to the CDC.
Black women are also more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.
"A Black woman doesn’t have to be poor for her life to be at stake and for her baby’s life to be at stake," Ingram said. "When we step back and look at that, it’s a direct correlation to why we have disparity in Black babies’ mortality as well."
The top five causes of infant mortality in the U.S. are birth defects, preterm birth and low birth weight, maternal pregnancy complications, sudden infant death syndrome and injuries, according to the CDC.
At least two of those causes -- preterm birth and low birth weight and maternal pregnancy complications -- often start with the type of care the mother receives during pregnancy, according to Rachel R. Hardeman, Ph.D., an associate professor at the University of Minnesota School of Public Health and founding director of the Center for Antiracism Research for Health Equity.
"What we know is that the stress and the cumulative disadvantage of racism throughout the life course brings Black women into pregnancy at less than optimal health," she told GMA. "It’s literally sort of the wear and tear on the body, a chronic stress that’s taking a toll on the body and prompting these biological changes in many women that then affect their health and the health of their babies."
Hardeman continued, "And not only that, but then they come into a health care system that historically has not provided equitable care to Black people."
The issue of disparities in health care for Black women and Black babies was front and center at the highest level of government this week when the White House issued its first-ever presidential proclamation marking Black Maternal Health Week.
"Over the years, I've heard many stories," Vice President Kamala Harris, who hosted a round table on the issue Wednesday, said. "Stories of women who are experiencing postpartum depression, only to be dismissed. Stories of women telling their doctors they were experiencing pain, only to be ignored. Stories of women who could not hold their newborn baby because that child had to be on life support or receive a blood transfusion after blood transfusion after blood transfusion."
"Black women deserve to be heard. Their voices deserve to be respected, and like all people, they must be treated with dignity," said Harris, who described what Black women face as a "maternal health crisis."
In her remarks at the round table, Harris cited the primary reasons for the maternal health crisis as "systemic racial inequities and implicit bias."
President Joe Biden has proposed $200 million for racial bias training for health care providers and reproductive health services. The American Rescue Plan, which Biden signed into law in March, included $30 million in funding for implicit bias training.
Implicit bias -- when people associate stereotypes or have attitudes toward other people without consciously doing so -- and institutional racism are primary drivers of unequal care buried deep in the health care system, according to Hardeman.
In a study co-authored by Hardeman that was published last year, Black newborns’ in-hospital death rate was found to be a third lower when Black newborns were cared for by Black physicians rather than white physicians.
"We’re not talking about individual racist physicians who are doing bad things to Black infants. That’s not at all what we’re seeing here," Hardeman told GMA. "What I think we’re seeing are health care delivery systems where racism is baked into all aspects of the system."
"It’s hard to identify, but it shows up in the ways that patients are cared for or not cared for in those systems," she said.
Hardeman this week began offering online education courses for perinatal providers focused on implicit bias, part of new training requirements in California under a law that went into effect last year.
She describes the education curriculum as one of the ways that health care systems can start to make the big changes needed to shift the outcomes for Black moms and Black babies.
In addition to making sure medical students and medical professionals are mandated to learn the health effects of structural racism and implicit bias, Hardeman wants to see health care systems meet standards of addressing structural racism and achieving equity in health outcomes in the same way they must meet safety and performance standards.
Making sure the health care staff is diverse is also critical, according to Hardeman, as well as giving Black providers the power to create new systems that suit the needs of the patients and families they serve.
"We have to be willing to reimagine what care should look like for Black birthing people and for everyone," Hardeman said. "I think there’s a real opportunity to rethink how we’re doing things versus sort of plugging the holes or stopping the bleeding."
For Ingram, she said that going through the death of her son made her a better physician, one who is more compassionate and more empathetic and who sees her patients as whole people.
She said health care providers have to "do better" when it comes to recognizing and understanding their implicit bias so that patients' needs are met and heard, and so that Black women and Black babies are kept alive.
"I explain it to my [OBGYN] partners like this, ‘Do you and your [sibling] view the world the same? Do you think the same?’ and they say, ‘No, I don’t view the world the same as my brother,'" said Ingram. "This is what it is. Everyone views the world differently. It’s not a right or wrong, you just view it differently."
"As practitioners, it means we have to step back, take a minute, kind of readjust ourselves and make sure that we’re looking at every patient that comes in the door for what are their risk factors? What are they bringing to the table? What do I need to educate them on? What are they high risk for? What do I need to take a little bit more time to talk with them about? What's the data here?" added Ingram. "It’s important to just be aware."