Health Headlines

ABC News(ATLANTA) -- The White House coronavirus task force is seeking to get ahead of the growing debate over how it's responding to racial disparities in coronavirus deaths -- particularly the much higher numbers and percentages in black communities compared to states as a whole.

The disturbing development in the crisis has become more apparent -- and controversial -- as states and cities begin to release data showing deaths by race -- data that has continuously been requested on a national scale from members of Congress, leaders in the black community and members of the press.

On Wednesday, the Centers for Disease Control and Prevention provided some limited data, as political pressure to do so increased.

But while the portion of data released by the CDC did reveal racial disparities on a national scale, there were caveats. The data was pulled from a small sample size during a limited time frame -- 14 states during the month of March -- and race and ethnicity data was only available from 580 patients hospitalized for coronavirus, out of a total of 1,482 patients in the report.

Still, it's the largest amount of national data to have been provided so far -- and it sheds new light on racial disparities seen in cities and states across the country that have collected such data.

According to the CDC, even though the racial breakdown from the population in the report was 59% white, 14% Latino and 18% black, 45% of hospitalized coronavirus patients were white and 8% were Latino, while 33% were black, "suggesting that black populations might be disproportionately affected by COVID-19."

On Tuesday, Dr. Anthony Fauci, the nation's top expert in infectious diseases, explained the disproportionate effects on the black community as an “exacerbation of a health disparity.” The same conditions that are far too prevalent in black communities also “lead to a bad outcome with the coronavirus," Fauci said.

“We have known literally forever that diseases like diabetes, hypertension, obesity and asthma are disproportionately afflicting the minority populations, particularly the African-Americans,” Fauci said at the daily White House briefing Tuesday evening.

“So we are very concerned about that. It is very sad. It’s nothing we can do about it right now, except to try and give them the best possible care to avoid those complications,” Fauci said — undoubtedly a disappointing reality for black Americans who are suffering at higher rates than white Americans living in the very same town, city or state.

Fauci noted that crises, like the coronavirus, can often “shine a very bright light on some of the real weaknesses and foibles in our society.”

“When all of this is over -- and as we said, it will end, we will get over coronavirus -- but there will still be health disparities which we really need to address in the African American community," Fauci said.

Experts like Spencer Overton, president of the Joint Center for Political and Economic Studies and a professor at George Washington University Law School, say providing racial data on coronavirus is the first step to stopping the spread in communities that are most overwhelmed by cases — and beyond.

“Collecting and publishing such demographic data about the entire country are essential. This would allow communities affected the most to receive the support they need, slowing the virus’s spread and saving lives,” Overton wrote in an op-ed published by The Washington Post on Tuesday.

“The disproportionate impact appears to be attributable to preexisting conditions — high blood pressure, heart disease, diabetes and inadequate access to health care — that make African Americans more vulnerable to the disease. But the handful of examples above raises an urgent question: Does the effect hold true for African Americans throughout the country? Unfortunately, there’s no way for the public to know,” Overton wrote.

Overton noted the data released from Milwaukee, Chicago and Louisiana has focused national attention on the issue.

Seventy percent of coronavirus deaths in Milwaukee have been African Americans, even though African Americans are less than a third of the county’s population. Similarly, in Chicago, African Americans are 30 percent of the population but 69 percent of coronavirus deaths; and in Louisiana, African Americans are 32 percent of the population but 70 percent of coronavirus deaths.

And in New York, Gov. Andrew Cuomo announced on Wednesday that new preliminary data showed the largest percentage of coronavirus deaths in New York City was among Hispanics. He, too, emphasized the need for more research to address the disparities across the board. Cuomo called for more testing in minority communities and more data research immediately.

"Why is it that the poorest people always pay the highest price?" Cuomo said. "Are more public workers Latino and African American? Who don't have a choice, frankly, but to go out there every day and drive the bus and drive the train and show up for work and wind up subjecting themselves to, in this case, the virus?

"Let's do the research," he said.

Cuomo highlighted another reason to collect data, which Overton wrote about as well: To help understand the social determinants that make it harder to avoid contracting coronavirus in poorer, often black communities, even though there is no medical research showing black communities are more susceptible to the virus, as White House coronavirus response coordinator Dr. Deborah Birx has repeatedly said.

“We don't want to give the impression that the African-American community is more susceptible to the virus. We don't have any data that suggests that,” Birx said on Tuesday. “What our data suggests is they are more susceptible to more difficult and severe disease, and poorer outcomes.”

"We really need to make sure that every household is aware of what it's going to take to protect the individuals in the household that have pre-existing conditions," she added.

Democratic members of Congress, including Sen. Elizabeth Warren and Rep. Ayanna Pressley, both of Massachussetts, as well as Rep. Robin Kelly of Illinois, Sen. Cory Booker of New Jersey and Sen. Kamala Harris of California, pointed out those socioeconomic factors in a letter to Human and Health Services Secretaty Alex Azar, who oversees the CDC, asking for public data on race and coronavirus.

“People of color are more likely to work in low-wage jobs that cannot be done remotely and to have fewer financial resources to draw on in the event of health problems or economic disruption,” they wrote. Working from home is one of the guidelines the White House has recommended to stop the spread of coronavirus, but many low-income jobs like grocery store employee or delivery driver still require leaving the house, and are important roles in keeping communities fed.

“Moreover, unemployment, food insecurity and unstable or substandard housing conditions may further perpetuate disparities in health outcomes for people infected by the coronavirus, most specifically among low-income communities of color. These factors may all combine to accelerate the effects of the outbreak in the most vulnerable communities,” the members of Congress wrote.

A number of nonprofits, including the NAACP and the African American Mayors Association, also wrote a letter directly to the head of the CDC, Robert Redfield, and the U.S. Surgeon General, Jerome Adams.

Asked about a possible solution on ABC’s “The View” on Wednesday, Harris, the senator from California, said FEMA, which is handling federal response, could direct more resources to communities that are already at a disadvantage as they fight coronavirus, both because of diabetes, asthma or other conditions that are more prevalent, and because now, testing and adequately prepared hospitals are harder to come by.

“Those who had pre-existing health conditions based on racial disparities, based on socioeconomic disparities, are doing even worse in the midst of this pandemic. And so it requires us to to address it in a way that also recognizes the historical nature of it,” Harris said.

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ABC News(TELLURIDE, Colorado) -- The effort to test every resident of San Miguel County, Colorado, for coronavirus antibodies -- including the mountain community of Telluride -- hit a snag after health officials said the private company conducting the tests couldn't handle the workload.

Last month, biotech company United Biomedical Inc. offered to pay to test every resident of San Miguel County for COVID-19 antibodies. Company founders Mei Mei Hu and her husband, Lou Reese, are part-time residents of Telluride. About 6,000 people were tested during the first round, according to the county.

Officials said the goal with widespread testing was to learn whether a person's blood showed signs of COVID-19 exposure. That information might help officials decide if widespread quarantines and stay-at-home orders should stay in place, or could be strategically lifted.

A second round of tests, however, has now been "delayed indefinitely" because the county says the coronavirus crisis has reduced staffing at United Biomedical by 40%. Only 1,600 of the nearly 6,000 tests taken during the first round of testing have been processed so far, county officials said.

"We will continue to evaluate whether or not it makes sense to pursue the second round of testing given the unexpected obstacles UBI's lab is facing," San Miguel County Public Health Director Grace Franklin said in a statement.

United Biomedical disputed the county's assessment, however, and said it is working to complete the remaining tests quickly.

"We are in continued communication with San Miguel County Commissioners regarding testing in San Miguel County and our partnership remains intact. Our lab was not compromised, and we're constantly working around the clock to process results from our friends and neighbors in San Miguel County," the company said in a statement to ABC News.

"Like all labs," the statement continued, "ours has experienced increased demand in the midst of an unprecedented global public health crisis. We have delivered almost 2,000 initial results from San Miguel County, and anticipate continuing to deliver expanded results as samples are continuing to arrive at our lab."

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OlenaKlymenok/iStock(NEW YORK) -- Your tabby cat may be in a different category than a tiger, but after one big cat at the Bronx Zoo was infected with novel coronavirus, pet owners have wondered if their furry friends at home could be at risk.

Here's what we know about pets and COVID-19

Can people get sick from pets?


Although there have been very few reports of cats and dogs testing positive for coronavirus overseas, the Centers for Disease Control and Prevention (CDC), said no pets in the U.S. have been sickened and there is currently no evidence that pets can pass coronavirus back to their owners.

"We do not have evidence that companion animals, including pets, can spread COVID-19 to people or that they might be a source of infection in the United States," the agency said.

While there is "very limited data published in the medical and veterinary medical literature thus far, we have to remember coronaviruses in general are known to infect animals," ABC News' chief medical correspondent Dr. Jen Ashton said.

Dr. Evan Antin, an exotic, small animal and wildlife veterinarian, told ABC News, "If your pet has COVID-19 it's far more likely that you gave it to them or somebody else in your household and you've already been exposed to that person as well."

Here's an important reminder from one of our FAQ images - Can pets spread #COVID19 to people? pic.twitter.com/TBJl6DrOZP

— AVMA (American Veterinary Medical Association) (@AVMAvets) April 6, 2020

How to recognize if an animal is sick?

"All of the tigers and lions that got sick had a cough, it was a dry cough, not a productive cough," Dr. Paul Callie, chief veterinarian at the Bronx Zoo, told ABC News. "There's no treatment that is known to work, so we've treated just symptomatically."

Can coronavirus live on fur?


Simply put, "we don't know," Ashton said. "It has not been officially and formally researched yet."

Research has shown that the virus can live on hard surfaces, but it is unknown whether it can live on animal fur.

What precautions can people take around animals?


The CDC and the American Veterinary Medical Association (AVMA) suggest if a human is sick and it's implied or assumed they have COVID-19, they should keep a distance from pets just as they would from others.

"If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with them," the CDC said.

"Obviously you can't use a bleach wipe on your pet -- maybe wiping them off with water once in a while if that's possible," Ashton suggested, reiterating that the most important preventative tactic is to treat the animal how you would a person and keep your distance if not feeling well.

What to do if your pet becomes ill or symptomatic?


"Talk to your veterinarian if you have questions about your pet’s health," the CDC recommends.

According to the AVMA, "There is no reason to remove pets from homes even if COVID-19 has been identified in members of the household, unless there is risk that the pet itself is not able to be cared for appropriately."

How are animals tested?


Nadia, the 4-year-old zoo tiger, was the first animal case of COVID-19 in the U.S. Her test was done at a USDA veterinary lab and is entirely different than the tests given to humans. It provides essential information about the virus and how it is transmitted in order to help keep people and animals safe.

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FrozenShutter/iStock(NEW YORK) -- Disney parks around the globe are honoring medical workers for World Health Day in light on the novel coronavirus pandemic.

World Health Day is celebrated annually on April 7 to commemorate all the nurses, doctors and health care staff working around the clock to keep people healthy. This year the day seemed to take on a particularly special meaning due to the fight against COVID-19.

“We are uniting across the globe with a message of thanks and appreciation to celebrate the brave healthcare providers who are helping so many,” Disney Parks editorial content director Thomas Smith said in a statement.

Although all Disney Resorts remain closed, the celebration kicked off at Shanghai Disney Resort, where the Enchanted Storybook Castle at the park’s center lit up with the words "thank you" written in several languages.

At Disneyland Paris, a floral arrangement spelling out “Merci” was put on display in front of the park’s castle.

Walt Disney World lit up its emblematic Cinderella Castle in bright blue in an effort to convey a sense of hope and gratitude. Cast members even created their own moment of thanks, holding up signs in front of the castle on Main Street U.S.A.

The original Disneyland Resort got creative, with cast members writing out “thank you” in flower petals next to the "Storytellers” statue in Disney California Adventure.

Cast members at Aulani, a Disney resort in Hawaii, also shared a heartfelt “mahalo” message.

We are uniting around the globe in a message of thanks and appreciation to celebrate the health heroes who are helping so many. 💙 As an expression of gratitude, our ohana shared a heartfelt “mahalo” message. https://t.co/vURqZGTIVn#ThanksHealthHeroes #DisneyMagicMomentspic.twitter.com/0jO1KGfdaS

— DisneyAulani (@DisneyAulani) April 7, 2020

All Disney Resorts remain closed until further noticed.

The Walt Disney Co. is the parent company of ABC News.


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narvikk/iStock(NEW YORK) -- Epidemiologists urge Americans not to gain a false sense of confidence and continue to practice social distancing, even as the number of confirmed cases of novel coronavirus appears to be slowing in some states.

In New York, the state most impacted by the virus, Gov. Andrew Cuomo said there was a "possible flattening of the curve" on Monday after the total number of hospitalizations, intensive care unit admissions and daily intubations were down. In New Jersey, the second-most affected state, Gov. Phil Murphy similarly said that the state saw its "very first potential signs the curve may be finally flattening."

Dr. Todd Ellerin, the chief of infectious diseases at South Shore Health, a nonprofit health system in southeastern Massachusetts, called the possible slowing in cases a "positive sign."

Yet, he said it was perhaps only made possible because of the practices in place now, making it all the more important not to do away with them completely.

"Remember, [social distancing] could be one of the major reasons why we're seeing less hospitalizations. … Does that decrease the hospitalizations you would normally expect by a third? Half? Those questions no one really has the answers to," Ellerin told ABC News.

"We can't say we're out of the waters and safe, but it is a good sign" he added.

Any sort of opening of the country would have to come slowly, according to Ellerin.

Such measures could include letting young people go back to school or camp, but ensuring that they still aren't visiting their grandparents, who are at higher risk.

The best possible scenario, Ellerin said, would be letting the healthy become immune to the virus after getting infected and have them slowly get back to work.

"I don't believe in ripping off the Band-Aid," he said. "I also realize that we can't live like this for that long. We have to find our new normal."

Dr. Eric Feigl-Ding, an epidemiologist at the Harvard T.H. Chan School of Public Health, was less confident in the possible decrease some states are reporting, noting that any sort of decrease is only significant if the rate of testing has remained the same or increased.

And for the testing that is happening, it doesn't apply to the majority of Americans. In New York, he noted that only those who have been hospitalized are tested, creating a gap in the actual number of cases.

"With all these caveats, I'm very skeptical if they're truly representing a drop in cases yet," Feigl-Ding told ABC News. "We don't know if it's real."

He thinks any real promise will come after numbers slow for at least a week.

"One day is a hint, but I want to see sustained improvements," Feigl-Ding said.

Both Feigl-Ding and Ellerin noted that the fatality rate will take longer to drop because, most often, people do not die immediately from the virus.

Feigl-Ding said he hopes people won't look at the numbers and gain any sort of false sense of hope. If anything, he said, social distancing becomes "even more important."

He gave the example of battling a wildfire.

"If you are super aggressive and put out a raging wildfire before it starts, people will think, 'Oh, you overreacted. Nothing happened,'" Feigl-Ding said. "Well, nothing happened because you were aggressive."

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ideabug/iStock(NEW YORK) -- Expectant women today are facing a question they likely never expected to have to ask in their pregnancy -- how to give birth during a pandemic.

The question has led some women to look online for answers, specifically on home births. Searches on Google for information on home births have increased markedly as the novel coronavirus has spread in the United States and pictures of hospitals full of patients with COVID-19, the illness caused by the coronavirus, have consumed the news and social media.

Some pregnant women are also suddenly looking at other birthing options in light of restrictions many hospitals have placed on the number of people allowed in the delivery room and in hospital visiting areas in light of the coronavirus.

“People are sort of in panic mode, they’re afraid to go into the hospital with the fear of the unknown,” Michelle Rhude, certified nurse midwife and owner of Bella Donna Midwifery in Jacksonville, North Carolina, told ABC News' Good Morning America. “They’re saying, ‘I need to change my plan. I don’t know if they'll allow my husband or mother in the birthing room.’”

Women as far along as 37 weeks pregnant are calling for interest in trying to change their birth plan, according to Rhude, whose company provides home birth, birthing center and doula services, among other needs. The hospital system in Rhude's area has instituted a new rule that says laboring mothers may have one visitor accompany them, forcing women to choose between their partner or doula.

Besides the possibility of not having their support person during labor and delivery, women are also fearful of being around sick people, Rhude noted.

“They feel if they stay home [to] have their baby they’re not going to have that exposure,” she added. “And then it’s, ‘I’m not even going to have my person with me.’”

Rhude said her services and resources differ from hospital maternity wards, and women typically do their homework over the course of an entire pregnancy. Some even plan for years.

“It’s hard a lot of women coming to you last minute who have not done all the research,” Rhude explained. “We want to help every woman, we in this time of desperation, but is it has to be the best choice.”

Doctors too are expressing their concerns about the complications that could arise from women making last-minute decisions to give birth outside of a hospital.

"Obstetricians in the United States are concerned about home births because we don’t have a rigorous system in place where if things start to become abnormal we have an easy and safe way to transfer women to the hospital," Dr. Elizabeth Langen, a practicing OBGYN and clinical associate professor at the University of Michigan, told GMA. "Results for home births in the U.S. are not the same as they are in other countries."

"My concern is that if people are choosing to have a home birth who have a higher risk of complications than people who generally have home births, then we might see harm come to people because they’re choosing a riskier location of delivery," she added.

Here are more pressing questions answered about a home birth versus a hospital birth in the time of coronavirus:

How common are home births?

Home births are on the rise in the U.S., data shows.

Approximately 35,000 births, or just under 1%, per year occur in the home in the U.S., according to the American College of Obstetricians and Gynecologists (ACOG).

Who should not have a home birth?

Women who are in a high-risk pregnancy should not consider a home birth, experts say.

Other disqualifying factors for a home birth include: Being pregnant with more than one baby; having had a previous c-section birth; being breech (i.e. the baby's buttocks and/or feet are positioned to be delivered first); maternal medical conditions, like high blood pressure and gestational diabetes; and high-risk fetal issues.

What are the risks of a home birth?

Home births are associated with a “twofold increase in perinatal death” according to a 2017 position paper by ACOG. Home births are also associated with a triple risk of incidents of seizures and serious neurological dysfunction for the baby.

For the mother, the main risk factor in a home birth is related to potentially deadly bleeding.

The coronavirus pandemic also presents a unique risk because emergency services are backed up in some areas with COVID-19 patients, noted Langen.

"If women are attempting a home birth and something terrible happens, a mom is bleeding or a baby is not breathing, generally you rely on an ambulance to transport you to the hospital," she said. "But that might not be an option for you if there aren’t as many EMS workers available in your area to help transport you safely."

Are hospitals safe for pregnant women right now?

The safest place to give birth is "still a hospital, hospital-based birth center, or accredited freestanding birth center," according to coronavirus guidelines issued by the American College of Obstetricians and Gynecologists (ACOG).

"Even the healthiest pregnancies can have problems arise with little or no warning during labor and delivery," ACOG says in its guidelines. "If problems happen, a hospital setting can give you and your baby the best care in a hurry. And studies have shown that babies born at home are more than twice as likely to die around the time of birth than those born in hospitals."

ACOG also added that, "Every woman has the right to choose where she will give birth. But it is important to not take any risks that might put you or your newborn’s health in danger, especially as there is a high risk for getting COVID-19. Talk with your ob-gyn or other health care professional about your birth plan and any concerns."

Langen also said that hospitals realize giving birth is not an elective surgery that can be delayed and are therefore taking as many steps as possible to ensure deliveries continue on in a safe environment.

"We understand that labor and birth needs to go on," she said.

What questions should women ask before a hospital birth?

Langen stressed that doctors and hospitals are there to help expectant women, especially when it comes to answering any questions.

"We recognize that everything has been turned upside down and we want to keep you safe," she said. "Talk with your doctor about how to make that happen ... ask your provider about what is safe to do and how the hospital is going to keep you safe."

With some hospitals temporarily relocating labor and delivery departments, expectant women should also ask their provider any logical questions about where they should go for the delivery, according to Langen.

She said women should also ask their doctors about what they can do now to prepare themselves for the safest possible hospital birth.

"What we’ve tried encourage for our pregnant patients is really aggressive social distancing to minimize the chance that they’re symptomatic when they come in for delivery," Langen said. "If you are any time near where you might deliver, we think keeping you and your support person free from symptoms is really important."

What should women consider before choosing a home birth?

"The decision to have a home birth safely really requires that you and your midwife look at your whole pregnancy and your medical health and the baby’s medical health to make sure that home birth is a safe option," said Langen. "There are women for whom home births have higher risks than others so you want to make this decision based not on this virus now, but on the whole pregnancy and safety for you and your baby."

Women who do choose a home birth need to be prepared to have a certified birth provider -- whether that's a midwife, a nurse or a doctor -- oversee the birth, according to Dr. Sarp Aksel, an OBGYN in New York City.

"I don’t think there’s any such thing as a low-risk pregnancy because any pregnancy can turn into a high-risk pregnancy in a matter of minutes," Aksel told GMA last year. "Having someone [leading the birth] who is well versed and experienced in that is really important."

Any woman considering a home birth should have a well-rehearsed and documented contingency plan in place, advises Aksel, including plans for quick and reliable transport to a nearby hospital, if needed.

In the time of coronavirus, women also need to talk with their certified birth provider about the precautions the provider has taken for their own safety.

"You want to talk about what personal protective equipment does the midwife have access to and how many homes did she have to go in and out of because this is also going to be a dangerous time for midwives," said Langen. "They may not be able to socially distance if they’re going in and out of people’s homes."

"And if your midwife is sick, she may or may not have a lot of backups to help with your birth," she added. "Looking at the whole system and how safe it is for you as an individual is important."

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SDI Productions/iStock(NEW YORK) -- Health care workers across the U.S. have risen to the occasion in combating the coronavirus pandemic. Skilled practitioners place themselves in harm's way to save lives -- but some medical professions face more dangers than others.

Anesthesiologists, in particular, have a vast skill set that makes them extremely valuable to care teams that manage critically ill COVID-19 patients, explains Dr. Yemi Odugbesan, physician anesthesiologist and adjunct professor of anesthesiology at Rocky Vista University College of Osteopathic Medicine.

But the particular procedure they perform that makes them so valuable also puts them in the most danger: intubation.

Because COVID-19 can result in severe respiratory issues, some patients need to be intubated, a lifesaving medical procedure in which doctors force a tube down a patient's throat, opening the airway and allowing patients to be placed on a ventilator.

“The most critically ill COVID-19 patients suffer from acute respiratory distress syndrome [ARDS], a complex inflammatory response that causes the lungs to fill with fluid,” Dr. Odugbesan explains. “The decision to intubate a COVID patient with ARDS is made if the patient rapidly decompensates, doesn't improve on high flow oxygen, starts to exhibit signs of multiorgan failure, or isn't able to sustain their blood pressure.”

Dr. Odugbesan notes that before a breathing tube is inserted, the patient receives a sedating medication, and mechanical ventilation is provided with a bag-mask.

But that's when things can get dangerous. Although the virus that causes COVID-19 isn't normally airborne, it can become "aerosolized" during this process, meaning the virus is kicked up in a fine mist.

“In addition," says Dr. Odugbesan, "once the breathing tube is in place, airway particles can become aerosolized during the brief period of time it takes to connect a patient to the ventilator.”

Throughout the intubation procedure, which generates the highest risk for droplet exposure, an anesthesiologist's face is mere inches away from the patient’s mouth.

If that weren’t nerve-wracking enough, anesthesiologists must also deal with the very real possibility that their face may be the last one a patient ever sees. Dr. Odugbesan explains that the mortality rate for COVID-19 patients who require intubation remains as high as 65-85%.

And despite changes in critical care practice that have improved mortality rates, Dr. Odugbesan said, “The prognosis for a COVID patient who experiences ARDS requiring intubation remains extremely poor and expectations for weaning patients off the ventilator are thus quite low.”

These are the concerns that anesthesiologists must address as they prepare for their typical 12-hour shifts. They mitigate their risk as much as possible by donning proper PPE for each intubation -- and because they may not know whether a patient has COVID-19 or not, they must gear up for every surgery as if the patient were COVID-19 positive.

“Members of our group have an extensive routine for donning and doffing PPE that often involves two people,” explains Dr. Odugbesan. They armor themselves in “hazmat suits, shoe covers, eye protection, N95 masks or special respirators, PAPRs (powered air purifying respirators), additional protective gowns, and finally two to three set of gloves.”

The stakes are high as ICUs across the nation are challenged with saving a dizzying number of severely ill patients. Anesthesiologists must multitask, balancing duties in the operating room for emergency surgeries with their responsibilities as critical care physicians.

Thankfully, says Dr. Odugbesan, “we are uniquely trained to treat patients in the fast-paced and ever-changing environment of the OR, which makes us adept at responding to acute situations in the ICU.”

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ABC News(NEW YORK) -- Tovah Haim gave birth to her second child two weeks ago in New York City, just as the coronavirus crisis was ramping up in the United States' most populous city.

On top of the worries most parents have after welcoming a new child, Haim has had to deal with concerns around COVID-19, the illness caused by the novel coronavirus. In her first days home from the hospital, she had to quarantine her older son, who had a fever, from the new baby.

"It's been petrifying for the last two weeks, at various points for different reasons," Haim told ABC News' Good Morning America. "It's just it's kind of like a rolling state of terror."

While some level of worrying is normal with a newborn, especially during the time of a pandemic, worries that turn irrational and incessant are signs of postpartum anxiety.

Around 10% of postpartum women develop anxiety, according to the Anxiety and Depression Association of America (ADAA).

Still, there is no category for it in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). Postpartum anxiety is most often just grouped under postpartum depression, which affects about one in seven women according to the ADAA.

Author Sarah Menkedick, the mom of a 5-year-old daughter, knows exactly what it feels like to have postpartum anxiety and to not have a diagnosis.

"I wrote this book because I went through basically about two years of really horrible anxiety," she told GMA. "And I didn't really know what to call it at that time."

"When I finally had this breakdown and realized I was suffering and this was horrible and I wasn’t even enjoying my time with my daughter, I started to think why did this happen and how did it take me so long to realize this was a problem?" she said.

Menkedick describes postpartum anxiety and its effect on moms in the U.S. in her new book, Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America.

"There are a lot of ways in which anxiety makes sense when you're a new mother," she said. "But it's very easy to sort of wander over the line and have it become this obsession in women's lives."

Physical symptoms can show when a new mom's anxiety has crossed over the line, according to Menkedick.

"If you're really feeling like you're sweating, your heart rate is going up, you're having these really physical responses to the anxiety, that's a sign that it's probably getting pretty intense," she said.

Other symptoms of postpartum anxiety include changes in eating and sleeping and the inability to sit still, according to the ADAA.

Menkedick says women and their loved ones can also pay attention to their daily activities and habits.

"Some of the women that I spoke with for the book were spending hours a day preparing their homes, hiding certain objects, cleaning certain things," she said. "SO I think one of the things to really pay attention to is how much time is this consuming, how much of your life is this consuming."

"Are you spending hours on Google? Are you spending hours cleaning? Are you not able to function because these thoughts are so overwhelming?," said Menkedick. "Those are the things to really pay attention to."

Even through the coronavirus pandemic, as new moms follow stay at home guidelines, Menkedick's advice for moms with postpartum anxiety is to, first, trust themselves and their instincts, and, second, to connect with other women.

"Certainly for all of the women I talked to, the number one way they found healing is talking to other mothers, saying, 'This is what I’m going through,' and having another woman say, 'Yes, I’m feeling the exact same thing,' and finding some affirmation and solidarity in that," she said. "I think that’s something women can really do now online, or in whatever way possible."

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sestovic/iStock(NEW YORK) -- The death of a loved one. A grave personal illness. Loss of income. These traumatic events rank among the most stressful experiences a person can endure, according to psychiatrists Thomas Holmes and Richard Rahe.

Amid the novel coronavirus pandemic, many American are facing these stressors.

The current pandemic is not just a medical tragedy. Even when the medical threat has disappeared, psychiatrists say people across the globe will battle psychological scars for years.

The documented connection between viral pandemics and psychological stress dates back more than 100 years ago, when Karl Menniger linked the 1918 Spanish flu pandemic with changes in psychiatric complications. The influenza virus most commonly affects the respiratory system, but the burden on neuropsychiatric diseases are under-recognized, he said.

A major study was conducted in 1920 in the United States to determine the impact of the influenza pandemic of 1918 on subsequent rates of suicide. Researchers concluded that the pandemic caused suicide to rise but a decline in alcohol consumption reduced national suicide rates.

Since then, many researchers have taken a closer look at the mental health impact during and after a pandemic. A study published in 1994 in the wake of the HIV/AIDS pandemic in The Journal of Crisis Intervention and Suicide Prevention suggested that those diagnosed with HIV were more likely to die by suicide and found that individuals with better support structures and less stress overall were less likely to die by suicide.

Since the Spanish flu pandemic of 1918, there has not been enough data gathered on the topic, given the absence of a pandemic of this magnitude and impact since. Experts say researchers will need to keep tabs on the mental health of the nation to see if the trends of the past hold true in the future.

President Trump recently announced that he is expecting the rates of suicide and drug addiction to increase due to the recent economic fallout. While no recent data can confirm or refute his claims, it is possible suicide rates will go up, but the future is uncertain.

"This is an unprecedented event for the vast majority of people. It is certainly reasonable to expect the risk of suicide increasing secondary to the economic and social fallout," Dr. Shailinder Singh who is a psychiatrist working in a psychiatric emergency room in a New York City hospital told ABC News.

However, he emphasized that "while some may argue this will directly correlate to an increased rate of death by suicide, there is simply not enough data, both current and historical, to suggest this will be the case," he added.

"Fear of losing one’s job is a major concern for those already suffering from mental illness," Singh added. With 6.6 million people applying for unemployment in the past month, there is major concern among mental health workers how this will impact depression and suicide rates.

According to the National Alliance of Mental Health, people are more likely to die of suicide if they also have experienced substance abuse, intoxication, medical illness, stress, have access to firearms, or suffered recent tragedy or loss. Drugs can create mental highs and lows that worsen suicidal thoughts. And more than 1 in 3 people who die from suicide are under the influence of alcohol at the time of death, NAMI reports.

Dr. Ken Duckworth, chief medical officer of NAMI told ABC News that rates of suicide aren't always closely tied with viral pandemics or high rates of unemployment.

"Economic instability and unemployment have been linked to increase in suicide," he said. "However in the past few years we have seen a rise in suicide despite economic prosperity."

Duckworth said that the pandemic seems to be fanning the flames, with NAMI seeing an increase in calls related to anxiety and depression over COVID-19.

"Most people are worried about having access to care, medications and whether supply of medications are running low," he said.

"People’s mental health needs, and call volumes to hotlines, may shift during the different stages of disaster, including in the recovery phase. It is very difficult to predict the duration or length of each stage, especially in a situation such as this, which carries a number of enduring stressors over time," John Draper, executive director, National Suicide Prevention Lifeline told ABC News.

Meanwhile, the pandemic has prompted many Americans to buy more firearms. The FBI reported a 73% increase in background check applications for gun purchases in March compared to the same month a year ago.

Experts say the wide availability of guns in America matters for suicide prevention because guns are more lethal than any other suicide method.

"We might see an increase in suicide in states where the ownership of guns are more acceptable such as Alabama, Ohio and Michigan," said Duckworth.

Meanwhile, one of the solutions for the pandemic -- social isolation -- could prove disastrous for mental health.

"Social distancing and isolation are triggers for people with mental health issues," said Singh.

"Humans being don’t do well with isolation," Duckworth added. However, he believes that technology will help keep connections alive as well as patient-doctor contact by telehealth visits.

“It will be an experiment. We would have to wait and see how technology will help lessen the impact of the pandemic," he said.

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.

For resources regarding mental health treatment NAMI HelpLine is a free, nationwide peer-support service providing information, resource referrals, and support to people living with mental health conditions, their family members, and caregivers. Call 1-800-950-NAMI or text NAMI to 741741 If you are located in NY and need mental health support, call 844-863-9314. Yalda Safai MD, MPH is a psychiatry resident in NYC and contributor to ABC’s medical unit.

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WDnet/iStock(NEW YORK) -- People around the world are taking precautions to keep germs at bay amid the coronavirus pandemic, like wearing disposable gloves or masks in public, but the temporary solution could lead to another problem: litter.

PWD crews are working very hard during this difficult time, but we need @CityOfBoston residents to help. We continue to find discarded rubber gloves and masks on our sidewalks and streets.

Please be respectful of your neighbors and dispose of your trash properly. Don’t litter! pic.twitter.com/QlyDeCj32q

— Boston Public Works (@BostonPWD) April 1, 2020

News feeds online have filled up with photos of used personal protective equipment strewn about on sidewalks, streets and other public areas.

If using plastic gloves when out in public or when shopping it is essential to dispose of them properly.

Please dispose of these gloves in the nearest bin or bring them home with you and dispose of them in the general waste bin. Littering is never acceptable.

#COVID19 pic.twitter.com/LZvhNXQB8n

— Galway City Council (@GalwayCityCo) April 6, 2020

And beyond the obvious environmental impact, there's a larger concern that the once-worn items have touched contaminated surfaces and could pose a biohazard threat for those who eventually clean them up.

"Gloves protect you against contact with infectious materials. However, once contaminated, gloves can become a means for spreading infectious materials to yourself, other patients or environmental surfaces," the Centers for Disease Control and Prevention said in its PPE guidance.

As we continue to wear disposable gloves and masks to protect ourselves, please remember to properly dispose of used protective equipment in the trash bin. Improper disposal could lead to exposure to biohazards. For more information, visit https://t.co/fFTPtDpg4H pic.twitter.com/CTi6ckSLID

— OC Waste & Recycling (@ocwaste) April 7, 2020

City officials and health experts have called out the litter bugs in their respective areas and urged people to do better.

There’s no shortage of #PPE litter in Columbia Heights. Please do better, neighbors. ⁦@PoPvillepic.twitter.com/HvwiynhGEn

— Stacey (@sas509) March 31, 2020

The CDC has recommended gloves as a temporary barrier while cleaning and disinfecting, going in public for essentials, but also calls for proper disposal of them.

Stop the spread of #COVID19 while working from home. Clean & then disinfect surfaces such as tables, desks, phones, tablets, & keyboards. For electronic devices, follow manufacturer instructions or use alcohol-based sprays containing at least 70% alcohol. https://t.co/f6qgn7X7sp pic.twitter.com/IA74ghWbJK

— Dr. Robert R. Redfield (@CDCDirector) April 6, 2020

The World Health Organization has said people are better off washing and sanitizing their hands than using plastic gloves because bacteria and germs that stick to gloves could be spread to another person.

For anyone who does wear gloves in public, the safest practice is to remove them and dispose of them in a plastic-lined garbage bin that can be tied shut and be tossed out properly. If someone's in public and can't find a proper trash bin, they should take the PPE home and dispose of it in a sealed garbage can.

Be careful if you’re thinking about sanitizing your gloves. You may be reducing their effectiveness, depending on the chemicals used. There are lots of charts online that tell you what your specific type of gloves will be effective against.

— Dr. Jacquelyn Gill (@JacquelynGill) April 5, 2020

After discarding PPE, individuals are advised to wash their hands thoroughly for at least 20 seconds.

This is becoming a very frequent sight.

Disposable gloves discarded on footpaths, in shopping baskets and on top of bins.

Littering is always disgusting but now even more so it’s a total hazard.

Someone else has to pick these up, please dispose of them correctly pic.twitter.com/zYrhlIhbWW

— James Browne TD (@JamesBrowneTD) April 6, 2020

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Halfpoint/iStock(NEW YORK) -- The nation's death toll from the novel coronavirus surpassed 10,000 in the last 24 hours, but even that figure belied a grim truth: the real number of deaths is higher, but no one knows how much.

"There is no doubt the official death toll is an undercount," New York City Councilman Mark Levine, the health committee chairman, told ABC News.

The U.S. Centers for Disease Control and Prevention (CDC) is well aware that the figures -- which keep going up -- do not tell the full story.

"The current data on presumptive and lab-confirmed cases and deaths are underestimates," CDC spokesman Scott Pauley said Monday. "Right now, we believe that the number of deaths we have reported paints an informative picture of the scope fo the epidemic."

In New York City, the current epicenter of the U.S. coronavirus outbreak, the number of dead stood at 2,738 as of Monday evening, according to city statistics. And getting a full picture of the disease remains as important as it is elusive in these first weeks of the American COVID-19 crisis.

Experts say the only way to get a full understanding of the viral enemy is to know how many it has killed and from there, who succumbed, if they were old or young, if they were in perfect health or likely suffering from some underlying condition that made them vulnerable. How fast did they die? And did they die of the virus directly or of something like heart failure caused by their bodies fighting off coronavirus?

As to that last question, Pauley said, "It’s likely that COVID-19 related deaths may not be included on a death certificate or COVID-19 might be a factor related to an individual’s death but not the main cause."

That type of information is more than just cold statistics, experts say.

Deployed by public health agencies, that data could help cities across the country and throughout the world properly prepare for the surge in hospitalizations and deaths that could occur as the disease strikes elsewhere. As it turns out, doctors and scientists believe, it was an underestimation of potential COVID-19 fatalities in New York City that has wrought serious consequences.

Dr. Robert Glatter, assistant professor of emergency medicine and an attending emergency physician at Lenox Hill Hospital in Manhattan, explained the crisis hit before key record-keeping protocols could be established.

"There is still no formal uniform platform for reporting coronavirus-related deaths in the US,” Glatter said. “Along with a lack of test kits or even rapid antigen identification kits, the reality is that many states have been unable to categorize deaths as COVID vs. non-COVID.”

The issue goes back to January, when the average American seemed unbothered by the coronavirus. Glatter said that even in February most hospital systems and medical examiners did not yet have access to COVID-19 testing.

"We did the best we could with what we had,” said one emergency department doctor in Philadelphia, speaking on condition of anonymity. “We didn’t have much and that’s a fact. I’m confident we saw patients who died of COVID before we could test. We suspected it, but couldn't confirm it so the death certificates never contained COVID as the cause.”

The doctor said it is also possible that, before public health officials detected community spread within the US, many people who died of the coronavirus disease were diagnosed simply with influenza-like illnesses or pneumonia.

Now, with the public and private hospital networks in New York City overwhelmed to the point of drowning, there are no resources or time to test samples from the dead or resolve statistical problems, officials acknowledged. At the moment, hospitals in New York City are only testing for novel coronavirus among hospitalized patients.

With limited resources reserved for the severely ill, many are dying before getting tested or while test results are pending, city officials said, and there simply is no opportunity to conduct post-mortem testing -- something routinely done in normal times.

According to Levine, the number of deaths at home in New York City has grown 10-fold since the end of last week, even as hospitalizations for trauma and other emergencies have dropped to nearly nothing.

"Normally we have 20 to 25 deaths at home and now we are at 200 to 215,” Levine said, explaining that coronavirus would likely be the only way to explain such a spike.

Medical examiners offices across the country are now pitching in amid the crisis, shifting resources away from typical forensic pathology work to help with identifying the cause of death for the growing numbers of people dying at home -- because that work is so important.

“We are helping because we have experience in death and know about management and storage of dead bodies, but these cases are not the usual cases that come to us,” said Sally Aiken, chief medical examiner in Spokane, Wash., and president of the National Association of Medical Examiners.

In her own community, Aiken said anyone who has died at home and is suspected of having COVID-19 would be tested after death with a nasal swab, but she admitted that could change if testing were to become more limited.

"If there are enough deaths, there is a point it will overwhelm the jurisdiction, no matter the size and everyone will have to make practical decisions that are not pretty to think about,” Aiken said. “We have to understand that at some point we may not be able to test everyone or look at every body.”

That is what has happened in New York City, the nation’s largest city and the site of the worst outbreak of coronavirus in North America.

"There is no swabbing of deceased individuals anymore and unless the medical examiner has knowledge of a confirmed coronavirus test, then they aren’t being marked down as having coronavirus,” said Levine, whose committee has oversight for the Office of the Chief Medical Examiner.

The CDC last month issued guidance on postmortem specimen collection of suspected COVID-19 deceased patients to ensure consistency across state response, but Aiken said she doubts there would be a “uniform response to the death of COVID-19” because of the lack of a “uniform system” across medical examiner offices – something that could also lead to coronavirus deaths being omitted from the stats.

And, she said, the many patients with underlying conditions who are dying before they can even get to a hospital are also likely to be counted inaccurately.

"You have a lot of [emergency medical services] workers who are pronouncing people dead from things like cardiac issues,” Levine said. “Are those coronavirus victims? Probably are, but they are not being categorized as such in death."

To try and get a more accurate picture of the crisis, the CDC last week issued updated guidance for certifying deaths due to COVID-19 – protocols similar to those in place for pneumonia and influenza. According to the new directions, if a patient has died from pneumonia, for example, but was also tested positive for COVID-19, someone is required to specify whether COVID-19 played a role in the death and whether it was actually the underlying, primary cause of death.

"Ideally, testing for COVID-19 should be conducted but it is acceptable to report COVID-19 on a death certificate without this confirmation if the circumstances are coming within a reasonable degree of certainty,” according to the new CDC protocols, though coronavirus still cannot be listed as the primary cause of death without a confirmed lab diagnosis.

Cécile Viboud, a staff scientist at the National Institutes of Health (NIH) who specializes in the mortality associated with infectious diseases, said it will likely take years to know the actual death toll of the contagion that has nearly paralyzed much of the nation.

In previous research on the 2009 H1N1 pandemic, Viboud said she concluded that only 50% of the deaths attributed to the disease were correctly labeled.

When it comes to COVID-19, she said it's hard to predict how far off the U.S. will be. Experts said there are other factors that make the grim accounting even more challenging. For one thing, the vast majority of those who die from COVID-19 are older or have other ailments, making it harder to pinpoint the precise cause of death. Plus, experts will have to wait years before they can accurately quantify the number of people who may have died indirectly from the pandemic.

“Everything we're doing to flatten the curve has major societal and financial impacts that can increase death rates,” explained Samuel Scarpino, who leads Northeastern University's Emergent Epidemics Lab. For instance, he said, there can be “indirect mortalities because a hospital, for example, doesn’t have a ventilator available for a non-COVID-19 patient.”

Undercounting the death toll impedes policy makers’ ability to understand severity of the disease, effectively allocate resources, or make decisions regarding school and business closures, experts and public health officials agree.

The emotional toll is no less important. Funeral homes are overwhelmed by the number of deceased bodies and funeral directors have said they are worried for the safety and health of their own employees asked to bury and handle bodies who may have been infected with COVID-19.

Family and friends are also left to wonder whether have been exposed to the virus and are contributing to its spread, without realizing it.

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Moyo Studio/iStock(NEW YORK) -- After a trip to the grocery store these days, does re-entering your home leave you wondering what level of hazmat decontamination is necessary?

We asked Dr. Angela Rasmussen of Columbia University -- a researcher who studies viruses, including the one that causes COVID-19 -- how she disinfects when returning home from the store.

What She Does

1. Use hand sanitizer in the car

Rasmussen says the process starts when she gets into her car in the parking lot.

"I sit down I get my hand sanitizer out," she said, noting she spends about 20 seconds rubbing it around her palms and fingers. "I put some on the steering wheel, too," she added.

2. Avoid touching your face

Rasmussen says she’s really careful not to touch her face until she gets home.
 
3. Immediately wash hands at home

Once home, Rasmussen said she takes off her jacket, places her bags inside the door and immediately washes her hands.

She also takes off her shoes but adds, "that’s not corona related, it’s because outside is gross and I like to be barefoot in my house."
 
4. Put groceries away

Rasmussen said she puts her groceries away -- and then washes her hands again.

5. Clean your phone

If she used her phone while on her journey, Rasmussen said she wipes it down with a disinfectant wipe or alcohol.

"Phones are a potentially higher risk for fomite transmission, transmission from surfaces because they are in close proximity to both your hands and your nose and mouth," she said.

After that, she said she feels fine going about her normal activities at home.

What She Doesn’t Do

Wash bags


Rasmussen said purses, jackets and fabric don’t usually need any special attention, adding "there’s very little evidence that virus transmits from clothing."

But she adds that if you think you or your jacket or bag has been in "direct contact with someone coughing or sneezing," a wash is a good idea.

Change or shower

She also doesn’t change her clothing or shower/wash her hair.

"The likelihood of having a significant amount of virus on your hair that could get on your face or in your mouth is very low," Rasmussen said.

But she adds, "If people feel more comfortable changing clothes or showering, they are welcome to do that, but the risk -- unless you had direct contact with someone pretty sick -- is pretty low."

Wipe door handles on every trip

She doesn’t wipe her door handles after every trip out, but she does clean them sporadically.

"Those are high-touch surfaces, so when we’re receiving deliveries, we have more opportunity from other people outside our home to be in contact with them," she said.

Dr. Rasmussen reminds people that this disease is primarily spread through respiratory droplets encountered through close, person-to-person contact, and she says germs on surfaces degrade and become less effective at infecting people over time.

"Viruses can’t reproduce without a host, so any virus on a surface is going to immediately begin to be less infectious," she said.

And while a study published in The New England Journal of Medicine says the disease can exist on surfaces like cardboard for 24 hours, and plastic and metal for 72 hours, the longer it’s outside the body, the less potent it becomes.

"Over that time, the amount of infectious virus decreases," she said.

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Peter Fitzpatrick/U.S. Navy(NEW YORK) -- The U.S. military is 3D-printing face shields, designing reusable plastic N95 masks and sewing surgical masks to increase the supply of critical medical equipment as hospitals across the U.S. work to combat the coronavirus pandemic.

Nine Navy and Marine Corps commands began their 3D-printing efforts on March 28 after the Federal Emergency Management Agency requested the initial production of 220 medical face shields, the Navy said in a news release.

Days later, the assistant secretary of the Navy for research, development and acquisition authorized all of its commands to support FEMA requests, saying that the country is in a national emergency so they "must engage accordingly."

The U.S. military is uniquely poised to assist in the production of personal protective equipment because of its expertise in additive manufacturing, or 3D printing.

The Marine Corps' Advanced Manufacturing Operations Cell (AMOC) was the first to receive FEMA's request for 220 face shields before alerting other Department of the Navy manufacturers.

"Every (additive manufacturing) producer I reached out to stepped up," said Marine Capt. Matthew Audette, an advanced manufacturing project officer with AMOC. "It speaks volumes of our additive manufacturing community that every group was confident that they could produce the entire request on their own. We broke it up to distribute the load."

According to the Navy, the department is now working with the Pentagon and industry "to determine the volume and scope of (additive manufacturing) requests, the capacity to manufacture and distribute production across sites and ensure quality standards."

And those efforts are extending across the entire U.S. military.

Some Air Force instructors have started 3D printing, not only face shields, but reusable plastic N95 face masks, the service said.

Instructors with the 312th Training Squadron's Special Instruments Training course at Goodfellow Air Force Base in Texas were inspired by similar efforts they saw on social media.

“We saw other people 3D printing medical supplies, and we thought we should try printing things like face masks and face shields,” said Master Sgt. Manuel Campo, special instruments training flight chief.

The instructors found a free model online for a 3D-printable, high-efficiency filtration mask designed by a neurosurgeon in Billings, Montana, who worked with a dental company to create the masks.

The group plans to present their prototypes to a medical group to see if they can meet hospitals' needs during the pandemic.

At Joint Base Lewis-McChord in Washington, 1st Special Forces Group soldiers who normally use sewing machines to repair parachutes are now producing surgical masks, according to the Defense Department.

The Group Support Battalion is creating the masks, along with prototypes for respirator masks and 3D face shields, for its local Madigan Army Medical Center and regional partners.

The Aerial Delivery Platoon is already able to produce 200 masks in a day with expectations to eventually produce 1,000 to 1,500 masks per week, said Army Lt. Col. Christopher S. Jones, the battalion's commander.

"I believe this is a phenomenal effort to help our health care professionals and fellow Americans," Jones said. "We're collaborating with (Army Special Operations Forces) and conventional forces across the Army to make a difference. The effort in and of itself is a worthwhile exercise in how to innovate to provide solutions, especially as the U.S. military has the best capability in the world."

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Chainarong Prasertthai/iStock(NEW YORK) -- The national hotline providing emergency help to people suffering from emotional distress has received nearly nine times more calls than it did this time last year, with tens of thousands of Americans reaching out for assistance amid the coronavirus crisis, according to U.S. officials.

Federal officials on the front lines of the U.S. government’s pandemic response have privately warned members of the White House and Department of Homeland Security that many more Americans will find themselves in “dire straits” over the coming weeks, and that U.S. agencies have yet to properly prepare for the unfolding “mental health crisis.”

“I am very concerned,” said one U.S. official.

Though the Trump administration has recently approved hundreds of millions of dollars in federal funding to boost mental health services, the official suggested even that additional money may not be enough to support the crisis counseling that will be needed.

Last month the “Disaster Distress Helpline” at the Substance Abuse and Mental Health Services Administration (SAMHSA) saw an 891% increase in call volume compared with March 2019, according to a spokesman for the agency, which is part of the Department of Health and Human Services.

In fact, this March -- ending a little more than a week ago -- saw 338% more calls to the helpline than in the month before, when the deadly virus began to take hold inside the U.S. homeland, and government officials began taking more extreme measures to stop its spread.

The agency's spokesman would not offer specific total figures, but the U.S. official said that last month the agency received more than 22,000 calls and text messages seeking help.

Nevertheless, over the past several weeks, mental health has only been discussed sporadically at the daily televised briefings from the White House.

Last week, on March 29, President Donald Trump suggested it is "common sense" to expect a “massive” jump in mental health issues.

“You’re going to have massive depression,” he said. “You’re going to have depression in the economy also. … [Expect] massive drug use, massive depression, mental depression, massive numbers of suicide.”

Two days earlier, Trump signed the $2 trillion emergency relief package known as the “CARES Act,” which set aside $425 million for SAMHSA “to address mental health and substance use disorders as a result of the coronavirus pandemic." Another $100 million is marked to supplement the agency's federal grant programs, according to Health and Human Services.

The bill also included $250 million for “Certified Community Behavioral Health Clinics” to increase access to mental health care services, and another $50 million for suicide prevention efforts, according to HHS.

A White House official pointed to additional funding aimed at supporting mental health among military veterans and Native Americans.

According to the SAMHSA spokesperson, his agency has been working “very closely” with other federal agencies to address growing mental health problems and to relax federal restrictions so that people can more easily access the help they need.

But the U.S. official described federal efforts so far as still insufficient to address what the official believes will be happening on the ground in the weeks ahead, especially as the need for crisis counseling expands.

“Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children,” SAMHSA noted on its website devoted to the coronavirus.

Many are suffering from fear and anxiety about stay-at-home orders, “social distancing,” supply shortages and wide-scale unemployment. Homeland security officials have privately worried that already-unstable Americans could be propelled to violence by stress associated with the pandemic.

There are 57.8 million Americans currently living with mental or substance use disorders, according to SAMHSA.

The Disaster Distress Helpline is operational 24 hours a day, every day of the year. Its staffers “provide counseling and support before, during, and after disasters, and refer people to local disaster-related resources for follow-up care and support,” according to the agency's website.

Even before the coronavirus crisis hit, agencies like the SAMHSA received limited federal funding for their efforts. And while the mental health agency's budget has actually increased in recent years under the Trump administration, which has seen some of the nation’s worst mass shootings ever, the administration is seeking a slight cut in that funding for 2021, with a total request of $5.7 billion. Other agencies saw cuts as well.

A White House spokesman did not respond to an email seeking on-the-record comment for this article. And a message on Monday seeking comment from the Office of the Assistant Secretary for Preparedness and Response at HHS was not immediately returned.

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Rike_/iStock(NEW YORK) -- Following the Centers for Disease Control and Prevention's new recommendation that Americans wear cloth face masks in public, especially in areas with significant COVID-19 spread, many are asking which materials offer the best protection against the virus.

Americans can use "cloth face coverings fashioned from household items or made at home from common materials at low cost," the CDC website says.

Dr. William Schaffner, medical director for the National Foundation for Infectious Diseases, said it's easy to get "hung up on the materials."

"The concept is to get something in front of your face, even if you’re tying a bandana in front of your nose and mouth," he told ABC News.

Masks work in two ways, Schaffner explained.

They prevent particles from exiting the mask wearer's nose and mouth but masks also prevent outside particles from getting inside the wearer's nose and mouth. Still, the data to support wearing cloth masks to keep particles out, and thus stop the mask wearer from getting sick, is thin, he said.

In other words, wearing a cloth mask probably won't protect you. But that doesn't mean you should ignore the CDC's recommendation to wear one.

"The utility of a mask to inhibit what's going out is pretty good," Schaffner said.

There's mounting evidence that a significant number of individuals who contract the virus may spread it before developing symptoms, or may be asymptomatic.

"This means that the virus can spread between people interacting in close proximity -- for example, speaking, coughing, or sneezing -- even if those people are not exhibiting symptoms," the CDC notes. "In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain."

While the personal protective benefit of wearing a mask may be low, the benefit to society at large is real.

"You can protect those around you by wearing a mask and they will protect you," Schaffner said. "If we all do that, it makes it more difficult for the virus to move from one person to another."

The new recommendations do not mean that Americans can relax other public health measures, such as social distancing. Instead, they should wear facial protection while continuing to keep at least six feet between themselves and others, while also remaining at home whenever possible.

Americans also "shouldn’t go out and buy masks that otherwise should be used in health care settings," Schaffner noted. While N95 masks are more effective at keeping particles out and better protect the mask wearer, they are in short supply and should be reserved for health care workers and first responders, according to the CDC.

For more information on how to make a cloth mask, see the CDC's mask-making tutorial.

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Jamestown Public Schools are hoping for the best, but planning for worse in regards to whether or not classrooms will remain closed for the rest of the 2019-2020 school year. District Superintendent B...

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