Health Headlines

iStock/Andrei StanescuBY: KELLY MCCARTHY

(WASHINGTON) -- As more consumers turn to plant-based meat alternatives, a new study that swapped Beyond Meat for beef, pork and chicken found that the non-animal protein products lowered some cardiovascular risk factors.

The small study published Tuesday in the American Journal of Clinical Nutrition conducted by Stanford Medicine found that when participants swapped their protein from animal to plant-based meat participants saw a drop in LDL cholesterol, reduced TMAO levels and in some cases, lost an average of two pounds.

"Among generally healthy adults, contrasting Plant with Animal intake, while keeping all other dietary components similar, the Plant products improved several cardiovascular disease risk factors, including TMAO; there were no adverse effects on risk factors from the Plant products," the scientists concluded from the 36 participants.

The researchers conducted this as a 16-week crossover study, which splits participants into two groups for dietary interventions.

Half of the participants ate at least two servings of plant-based alternative meat per week and half ate at least two servings of animal meat per week. After eight weeks, the people eating the plant-based "meat" started eating real meat for eight weeks, and the people eating real meat started eating plant-based "meat" for eight weeks.

This study did not include a washout period, which would ordinarily provide a small break in between the intervention switch in which participants go back to eating like normal for a bit.



Participants' levels of LDL cholesterol, sometimes referred to simply as "bad" cholesterol, dropped on average 10.8 milligrams per deciliter, which researchers found to be statistically significant.

The lead researcher Christopher Gardner, Ph.D., professor of medicine at the Stanford Prevention Research Center, said one of the main outcomes they looked to track was the levels of a molecule, trimethylamine N-oxide, or TMAO. TMAO has been linked to cardiovascular disease and Gardner called it "an emerging risk factor."

The scientists found that TMAO levels were lower when participants were eating the plant-based meat diets.

"For the participants who had the plant-based diet first, during which they ate no meat, we basically made them vegetarians, and in so doing, may have inadvertently blunted their ability to make TMAO," he said. "Whether this type of approach could be used as a strategy for decreasing cardiovascular disease risk remains to be seen."

Additional findings from the study included that participants lost two pounds, on average, during the plant-based portion of the study. They also found similar sodium intake and blood pressure levels between the animal-based and plant-based phases of the study, which they say debunks the myth that consuming plant-based meats results in higher sodium intake.

The real meat used during the meat intervention was a combination of beef, pork and chicken products. The beef product used 80% lean and 20% fat ground beef; while that is a common red meat product for most Americans, the meat itself had noticeably higher saturated fat per serving than did the plant-based "meat."

ABC News medical unit resident Nate Wood, MD, explained that a comparison using 90-95% lean ground beef or other lean meat products may have provided different results for saturated fat that likely would not have been present.

The "swap meat study" was funded by an unrestricted gift from Beyond Meat and researchers used the company's products to compare the health effects of meat with plant-based alternatives, however Stanford Medicine said in a press release said that Beyond Meat was not involved in designing or conducting the study and did not participate in data analysis.

Additional funding for the research was provided by the National Institutes of Health.

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atakan/iStockBy GENEVIEVE SHAW BROWN, ABC News

(NEW YORK) -- If there's one issue dividing parents at this moment, it's the back-to-school debate. And while it seems few people can agree on the right course of action for the 2020-2021 school year, there is one thing most parents can agree on: they're all a bundle of nerves.

That's why Dana Kimmell, a kindergarten teacher at Sundown Lane elementary school in Canyon, Texas, posted a comforting message on her Facebook page that's gone viral. A mother of a rising kindergartner herself, she knows firsthand the uncertainty parents feel. Her class returns to the school building next week.

"It's [kindergarten] the first step in the children's education and it should be exciting, not scary," Kimmell told Good Morning America. Although the state of Texas does not mandate mask wearing for young children, Kimmell's school district will require face coverings for all staff and students.

Her post reads in part: "Dear Kindergarten Parent, Let me help you understand what our babies are walking into. ❤️

Hi! Welcome to Kindergarten! I'm your teacher❤️, I'm so happy you are in my class! 😁 Look at my cool face shield!! Do I look like an astronaut? 👩🏻‍🚀 Maybe you'll get an astronaut helmet too! Oh I know you'll miss mama, this mama misses her babies! 👶🏼👦🏼 but GUESS WHAT....we get to see them again in just a little bit!!! ❤️Look! A new friend! Y'all are going to have so much fun at recess! It's time to go inside now....Give mama a HUGE squeeze, one you'll feel in your heart all day until you see her after school!!

It's time to wash our hands then find our spots! Let's learn a hand washing song! Are you ready? 🎵

Now let's learn our letters!! This is an A and it says "aaa" can you say it?? Do you hear it echo inside your face shield? Can you hear the sound you're making?"


Kimmell told GMA she's received "so much positivity" in reaction to her post. "Parents tell me they feel a sense of peace after they read it," she said. The school's received many of the items on its Amazon wish list since the post went viral, Kimmell said.

The kindergarten teacher said the first few days of school will have a lesson plan related to mask wearing and they will have fun with it. "We're going to pick super powers and the mask make them like superheroes," she said. The first book she'll read to her class? What Should Danny Do? -- a kids' book about a boy with the superpower to make good choices at school.

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sujit kantakad/iStockBy KELLY MCCARTHY, ABC News

(NEW YORK) -- Dentists are fighting tooth and nail to get back to business amid the ongoing COVID-19 pandemic.

The World Health Organization released its new recommendation that people should put off "routine" check-ups in areas where the virus is spreading until more is known about coronavirus transmission risk during dental procedures.

The American Dental Association fired back and said that it "strongly disagrees" with the guidance and argued that with the appropriate personal protective equipment, patients and professionals can safely operate.

The president of the California Dentist Association, Dr. Richard Nagy, told ABC News that doctors in their field of practice are well-practiced in disease control.

"Dentists have been experts in infection control for over 20 years due to the HIV AIDS scare," Dr. Nagy said. "So we're used to preparing our offices for infection disease control."

The Centers for Disease Control and Prevention, meanwhile, says dentists can operate in communities where the virus is spreading, but recommends additional protective equipment be worn by staff, including eye wear protection in addition to masks.

While there have been no reported clusters of COVID-19 outbreaks directly traced to dental offices, there were two separate Colorado Springs dental offices that recently reported staff members who tested positive for the virus.

Some dental workers have been on edge amid the ongoing spread of coronavirus.

"The problem with dentistry right now is nobody knows the risks," dental hygienist Sara Mercier told ABC News. "Everything we do, including just having a patient open their mouth and breathing, creates aerosols. And unlike other medicine, we cannot socially distance from a patient."

She continued, "nobody can look a patient in the eye and say, you are safe here and you're not in harm's way because the science is showing us that they probably are."

But Dr. Nagy said that most dental offices across the U.S. have taken the pandemic seriously and revamped offices, including adding ventilation, and strengthening sanitation and safety protocols.

"We really increased our knowledge of airborne base pathogens and prepare their offices in terms of enhanced PPE enhanced training for our staff," he explained.

What patients should expect ahead of going back into the dental chair

Dr. Simone Wildes, a Massachusetts-based infectious disease expert, told ABC News how to safely consider going to the dentist.

"Do a temperature check before you go in," she recommended.

"The waiting room is going to be pretty much empty of all the magazines and toys, they are no longer going to be in there," Wildes added of the minimal surface touch points. "They are going to be dressed entirely different -- covered in PPE."

Finally, she recommended looking for signs of sanitation measures.

"Make sure you're looking around to see whether or not the staff is cleaning up after each patient," Wildes said.

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Daisy-Daisy/iStockBy LAURA ROMERO, ABC News

(NEW YORK) -- At a time when nursing homes continue to be among the hardest hit settings in the coronavirus pandemic, new studies are beginning to offer insight as to why some facilities are seeing more cases than others -- and, according to one, how important nursing home employees themselves are to the fight.

A study released on Monday by The Journal of the American Medical Association (JAMA), found that across eight states those facilities that were able to maintain more staffing in the homes had fewer COVID-19 cases than staffing in homes the study rated as low-performing.

The study, by Harvard researchers, looked into outbreaks of coronavirus in California, Connecticut, Florida, Illinois, Maryland, Massachusetts, New Jersey and Pennsylvania. Researchers used federal reviews based on health inspections, quality measures and nurse staffing to see if facilities with poor performance ratings in those categories had more viral infections or deaths.

When it came to health inspection or quality measure ratings, the study found no significant difference in the burden of COVID-19 cases between the homes. But the data did suggest one interesting data point: Facilities with nurse staffing shortages may be more susceptible to the spread of the virus.

The report published by JAMA acknowledged the importance of infection control practices but pointed out that policies that provide immediate staffing support “may be more effective at mitigating the spread of COVID-19.”

The study used "mean staffing hours per resident by qualified nursing staff" as the metric for nurse staffing ratings.

Eric Carlson, a long-term care expert with the advocacy group Justice in Aging, told ABC News that when facilities don’t have enough staff, residents suffer from lower quality of care.

“When nurse aides are responsible for too many residents, they don’t have the time to follow the proper infection prevention procedures,” said Carlson. “It’s penny wise and pound foolish for facilities to short-staff facilities, since this research shows that overworked staff leads to infections and deaths."

Toby Edelman, a senior policy attorney for the Center for Medicare Advocacy, a nonprofit, organization that provides education, advocacy and legal assistance to help older people and people with disabilities obtain health care, told ABC News that nursing homes have struggled to meet federal standards on staffing levels even before the coronavirus pandemic.

“Nursing facilities with more registered nurses and higher nurse staffing levels in general are more effective in containing the coronavirus than facilities with fewer nurses,” Edelman said.

Meanwhile, a study released by the Centers for Disease Control and Prevention on Tuesday, centered on the need for long term care facilities to more closely monitor residents who regularly leave the facility for outpatient health care.

The study, which followed an outbreak in a Maryland nursing home, found that patients who need dialysis, a treatment for kidney failure, were more likely to have COVID-19, possibly because of their frequent exposures outside the nursing home to both community dialysis patients and staff members at dialysis centers.

According to the report of the study, the hospitalization rate for residents who received dialysis was higher than among residents not receiving dialysis.

The CDC report emphasized that nursing home residents who undergo dialysis are a particularly vulnerable population because they often have more underlying medical conditions like diabetes-mellitus, hypertension and heart disease.

“The issue in Maryland is another wake up call about the challenges of the spread of COVID-19 in nursing homes,” said Dr. Jay Bhatt, an internist in Chicago and an ABC News contributor. “The report underscores the grave risk COVID-19 poses to people that have chronic disease, are immunocompromised or on dialysis. COVID-19 has made it no secret that nursing homes are at high risk of spread, infection, and poor outcome.”

The report advised that clear communication between nursing homes and dialysis centers, and coordination of testing practices between the sites are key to preventing COVID-19 outbreaks.

“It is critical that long term care facilities and nursing homes have protocols in place to ensure that preventive measures we know work are in place to keep patients and their families safe,” Bhatt said.

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Ovidiu Dugulan/iStockBy ERIN SCHUMAKER, ABC News

(NEW YORK) -- U.S. counties predominantly composed of white people have reported the fewest coronavirus cases, while diverse counties have been hit disproportionately harder by COVID-19, new research shows.

Researchers analyzed publicly available U.S. Census data and found that while 22% of counties have a predominantly Black population, those counties accounted for 47% of COVID-19 cases and 54% of deaths as of June. That racial disparity held true regardless of geographic region or political affiliation and was the same both before and after reopening the U.S. economy.

Counties that were more than 93% white reported the lowest rate of COVID-19 infections, at just 188 per 100,000 residents, compared with 914 per 100,000 residents in counties that were less than 60% white.

It's not that infections spread quickly in tightly packed cities and more slowly in spread out rural areas, according to the study, which was published in the journal AIDS Patient Care and STDs by the Foundation for AIDS Research. Instead, the disparities existed in every segment of American society.

"We found the same racial disparity among counties in small metropolitan and rural areas of the U.S.," the researchers wrote.

In addition to being more likely to get sick and die from COVID-19, Black and Hispanic Americans are more likely to have personal experience with a fatal COVID-19 case among friends, families and acquaintances. In a June survey, 31% of Black Americans said they knew someone who had died of coronavirus, compared with 17% of Hispanics and 9% of Whites, a Washington Post-Ipsos poll found.

"The premature reopening of our economy has only worsened the COVID-19 crisis among communities of color irrespective of region or blue or red voting patterns," the amfAR researchers noted.

COVID-19 disparities have roots in redlining, structural racism

Similar to many other Black-white health disparities, the researchers pointed to structural racism and residential segregation as key factors.

Crucially, neighborhood segregation isn't an accidental phenomenon, but rather an intentional outcome of historical systems like redlining, a policy that took root in the 1930s where lenders would refuse to approve loans for properties in largely minority neighborhoods.

The same structural racism that created those neighborhoods is a key mechanism in COVID-19 disease and death inequality rates. A similar analysis in New York City found that neighborhood quality affected HIV diagnoses, where 65% of Black men diagnosed with HIV in New York City and 68% of new HIV diagnoses among Black men were in high-poverty zip codes.

Similar to Black-white disparities in HIV rates, structural racism puts people of color at greater risk for COVID-19 infections, complications and death, the researchers found.

"Neither luck nor genetics keep COVID-19 diagnoses lower in mainly white counties and higher in primarily non-white counties," Greg Millett, amfAR's vice president and director of public policy said in a statement. "Adapting programmatic and policy interventions that have worked for HIV may help, but the historic legacy of residential segregation and redlining will have an enduring effect on health disparities until we decide to fix it."

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narvikk/iStockBy DR. NATE WOOD, ABC News

As the world waits for a COVID-19 vaccine, concerns are already rising that it may not work in obese patients, arguably one of the groups that needs it most.

More than 1 in 3 Americans is obese, and the Centers for Disease Control and Prevention has said that obese people are among the groups more likely to get sick and die of COVID-19.

"We know from other vaccines that have been tested in obese populations that these individuals don't respond as well to these vaccines," said Dr. Matthew B. Laurens, a lead investigator at the University of Maryland for one of the United States' most advanced coronavirus vaccine trials by Moderna Therapeutics.

Research has long shown that vaccines against viruses like influenza and hepatitis B, as well as other disease-causing organisms like tetanus and rabies, are not as effective in obese adults compared to their thinner peers.

Evidence of this phenomenon goes as far back as 1985, when hundreds of hospital employees in North Carolina were vaccinated against hepatitis B and then studied to see how their immune systems responded. Researchers found that the vaccine was twice as likely to fail -- meaning it did not provide adequate protection against hepatitis B -- in employees with a higher body mass index compared to their colleagues with lower BMIs.

In 2017, researchers at the University of North Carolina, Chapel Hill reported similar findings in patients getting their yearly flu shot. In their study of over 1,000 participants, they found that obese adults were twice as likely to develop influenza or an influenza-like illness -- despite having been vaccinated against the virus -- compared to non-obese adults.

With 42.4% of the American population being classified as obese, and research identifying obesity as a major risk factor for COVID-19 infection and severe complications from the disease, this is giving some experts reason for pause.

"We recognize that while we're developing a vaccine for COVID-19, it might not work in all populations, including those who are obese. So that's a concern," said Laurens.

It's not entirely clear to experts why vaccines don't seem to work as well in obese patients, but there are a number of theories.

One thought is that the typical one-inch needle routinely used for immunizations is not long enough for use in obese adults. This is because the fat layer under the skin may be thick enough that the needle can't reach the underlying shoulder muscle, where the vaccine liquid needs to be deposited to have its best shot at working.

Another theory is that obese adults, because of their increased body mass, may actually need a bigger dose -- or even a booster dose -- of the vaccine to properly ready their immune system to fight off the virus.

A third theory has to do with how obese patients' immune systems work.

According to Dr. Leonard Friedland, the vice president and director of Scientific Affairs and Public Health for GlaxoSmithKline Vaccines, "Obesity triggers a chronic inflammatory state in humans." This constant, low-level inflammation could be what's blocking some vaccines from working as well as they do in thinner patients.

"It's a real issue," said Friedland.

But could the coronavirus vaccine be different and provide equal protection for both the obese and the non-obese?

"We don't know. I think you could say it's possible. The new technology is different," said Laurens, referring to the novel mRNA technology being used in the coronavirus vaccine trial he's currently spearheading.

For now, perhaps the only way to know for sure whether the vaccine will work in the obese is to include them in large phase 3 trials -- the last step before authorization from the Food and Drug Administration.

"It's important to enroll obese people, because they are likely to have associated chronic illnesses, and you really get to see if the vaccine helps those highly at-risk people," said Dr. Arthur L. Caplan, the Drs. William F. and Virginia Connolly Mitty professor of bioethics at the New York University Langone Medical Center.

Historically, obese people have been largely excluded from vaccine trials, because of these chronic illnesses, like diabetes and high blood pressure.

Coronavirus vaccine developers, however, are now attempting to combat this disparity by actively enrolling obese patients in their clinical trials.

"We think it's important to develop a vaccine that is going to work for everyone," said Laurens. "That's why we're trying to be as inclusive as possible in the phase 3 studies -- so that we can learn more about how to protect particularly the vulnerable populations, including the obese."

Nate Wood, M.D., is an internal medicine/primary care resident at Yale New Haven Hospital and a contributor to the ABC News Medical Unit.

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ABC NewsBY: KARMA ALLEN

(WASHINGTON) -- Researchers are pointing to an alarming medical study about fatal surgeries among Black youth, saying the data sheds light on why doctors and hospitals should to do more to confront their own biases.

The study, published in the journal Pediatrics, found that Black children are 3.4 times more likely to die within a month of surgery and 1.2 times more likely to develop postoperative complications after both elective and emergency surgeries, than white children.

The study, which examined data on 172,549 children who underwent surgery between 2012 and 2017, attributed some of the disparities to greater preoperative comorbidity burdens among Black patients, citing racial and structural inequalities.

Orthopedic operations and appendix removal were among the most common surgeries, according to the study. Researchers said there were few deaths overall, but disparities were undeniable: 23 Black children died within 30 days of surgery compared to 13 white children.

"Despite ongoing improvements in surgical care and apparent rarity of postsurgical mortality, racial and ethnic disparities in postoperative morbidity and mortality remain significant and persistent," researchers wrote. "Our overall aim was not just to highlight traditional, well-known race-stratified surgical outcomes but specifically to assess whether poor baseline health alone explains why AA children are more likely to die in surgical care."

Several past studies have shown that Black patients -- regardless of age -- are generally more likely to suffer postsurgical complications and die after surgery than their white peers, the study said, citing poverty and lack of health care as two possible explanations.

Olubukola Nafiu, the lead author of the study, said the results showed that healthy children generally had very low rates of death and complications after surgery. But Nafiu said it was surprising to see the vast differences in mortality rates and complications based only on race.

In the past, researchers hypothesized that Black patients tend to be sicker than their white peers, hence the higher mortality rates, but Nafiu's study specifically looked at young patients who were healthy ahead of both emergency and elective surgeries.

"So, what my team and I did was to flip the script a little bit by looking at a relatively healthy cohort of children," he said. "We didn't expect this, but even in this relatively healthy cohort of children, being African American was associated with higher mortality rates compared to being white."

The study doesn't explain the driving forces behind the disparities, but Nafiu said socioeconomic background, insurance status and hospital quality of care could all play a part.

"We know for sure that when it comes to African Americans, it tends to take a longer time for them to be seen by doctors and it takes a longer time for them to get referred," Nafiu said. "So you may have two who look relatively healthy on the day of surgery, but the duration of the disease, and how long it took them to get to the surgeon maybe will be very different."

The rate at which patients return home after surgery also has "important implications in the overall recovery process," he added.

Black patients are much more likely to receive care at low performing or inner city hospitals, according to the study, but researchers said that may not be the driving force behind the discrepancy. The hospitals examined in the study were all part of the National Surgical Quality Improvement Program, which indicates that they had the resources necessary to make quality improvement a priority, Nafiu said.

Growing evidence suggests that implicit bias might play a role in how well patients are likely to fare in the medical system, with minority patients more likely to do better when they are treated by doctors who look like them.

The alarming study comes as some of the country's most prominent medical organizations mull policy and practice changes amid pressure from civil rights advocates who have complained about systemic racism within the medical field.

Last month, the American Academy of Pediatrics formally apologized for past racism toward its first Black members: Dr. Alonzo deGrate Smith and Dr. Roland Boyd Scott. The doctors were admitted to the AAP in 1945, six years after their initial applications were rejected based on race.

"This apology is long overdue," AAP's president, Sally Goza, said in a statement. "We have accomplished a lot of good things for children. But we must also acknowledge where we have failed to live up to our ideals. That is the only way we can work together to build a better future."

In a policy statement titled "Truth, Reconciliation, and Transformation: Continuing on the Path to Equity," the organization revealed decades-old transcripts from executive board meetings, where officials "lay bare some of the racist attitudes and beliefs of early AAP leaders," the organization said.

"In the United States there is a tendency to be ahistorical when it comes to race," the organization wrote in the statement. "The lack of acknowledgment, or worse, the intentional whitewashing of history and the longitudinal relationship of 400 years of oppression on the present-day expression of racism is not uncommon."

Nafiu said he hopes to see more medical organizations and institutions acknowledge previous acts of bias and offer to correct them. To promote fairness, more medical organizations have been encouraging providers to take implicit bias exams. Still, Nafiu said, more needs to be done to investigate how the dynamics of physician-patient relationships and subsequent care might be impacted by bias.

Overall, he said the study exposes leaks in the pipeline of doctors, and notes the unequal representation between doctors and patients. Black people account for about 13% of the U.S. population, but only 4% of the country's doctors are Black, according the Association of American Medical Colleges.

"It's at the forefront now, in terms of organizations talking about implicit bias and how to address [it]," Nafiu said. "So, we're trying to mend some of those cultural gaps and help professionals understand how cultural differences can inform their perceptions."

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guvendemir/iStockBy KATIE KINDELAN, ABC News

(NEW YORK) -- When Diane Borsvold's husband and children tested positive for COVID-19 in June, it was her 10-year-old son, M.J., who suffered the most emotionally.

"He broke down crying," Borsvold told ABC News' Good Morning America. "We told him that he was having these symptoms and probably had COVID-19 as well and he was like, 'No, I don't have it. I don't have it.'"

M.J., a fifth-grader in San Antonio, Texas, said he remembers having fears he would die when he tested positive for COVID-19.

"I had so many thoughts to my mind," he told GMA. "The biggest one was, 'Am I going to survive this?' That was my biggest fear, of dying or being rushed to the hospital."

M.J. and his immediate family members all recovered from the virus but said his anxiety has stayed as friends and family members continue to be diagnosed and he worries about the school year ahead.

Across the country, millions of students are returning to newly-designed classrooms with new rules, like social distancing and mask wearing, or they are spending the start of the school year in front of a computer screen at home, doing virtual learning, or doing homeschooling.

Either way, the changes and uncertainty caused by the coronavirus pandemic are already having an impact on children's mental health, data shows.

At the end of the last school year, 29% of parents said their child was "already experiencing harm" to their emotional or mental health because of social distancing and closures, according to a May Gallup poll.

"Socialization is important to kids' development because it is a part of their normal, day-to-day activities," said Kenya Hameed, PsyD, a neuropsychologist at the Child Mind Institute, a national non-profit organization focused on kids' mental health. "That break from normalcy is the part that is having the negative impact on kids."

As the new school year begins, children and parents alike have to see the pandemic as more of a "chronic issue," and not something that was as short-term as it seemed in the spring. With that understanding, the way they approach the new school year needs to change, too, according to Hameed.

Here are seven tips from Hameed and Dr. Harold Koplewicz, president and medical director of the Child Mind Institute, on how parents and students can prepare mentally for the school year ahead:

1. Create an at-home learning space for your child.

Kids need a dedicated place for learning and school work in the house, even if it is a dining room table that becomes a classroom every morning, according to Koplewicz.

"They need a place where, 'This is school, this is different than any other part in the house,'" he said.

2. Focus on skills rather than assignments.

Parents should work now to figure out how their kids learn, whether it is that they work fast or work slowly or work outside-the-box, and adjust accordingly, recommends Koplewicz.

He also stressed that parents should remember the country is in the middle of a pandemic and to give themselves, and their kids, some slack, focusing on the skills they're learning rather than on if they are following each assignment precisely.

"If the assignment isn't working well for your child in the format their teacher presented it, it's appropriate to adjust it," said Koplewicz. "For example, if your child absolutely refuses to write out spelling words on a worksheet from the teacher but they're happy to recite them while jumping rope, you know what, COVID. Let's not sweat the small stuff."

3. Develop a social life with your kids.

Being without friends both inside and outside the classroom is difficult for kids, so parents need to recognize that and get creative, according to Koplewicz.

"Is there a family they trust who is close to them who is following all the rules and their children could have a social interaction with?" he said. "If not, how can your family [socialize] with screens?"

Koplewicz said screen time can be beneficial for doing things like having a FaceTime or Zoom pizza party with another family or friend, but also make time for family activities like movie nights, board games and cooking.

Parents should also use this time to develop a social life not just for their kids, but with their kids and make the relationships and the qualities of interactions at home more meaningful, according to Hameed.

"A lot of times kids gravitate to their friends because they feel like their family really doesn't understand them," she said. "By working on trying to have positive interactions in the home, that's going to have a positive impact on a kid's mental health."

4. Stay active with your kids.

Kids who are doing virtual learning will miss recess time and physical education classes at home, while kids who are attending school in person may also miss out due to social distancing guidelines.

Koplewicz recommends taking older kids on a jog or walk in the morning or evening, or going to the high school track as a family, if social distancing there is possible.

For younger kids, Koplewicz recommends taking a break three times a day to do 10 jumping jacks.

"That physical activity is really important," he said.

5. Practice gratitude and focusing on the present.

Koplewicz recommends parents get in the habit of asking their kids at dinner what they are grateful for in order for families to step back from day-to-day life and say, "Let's remember we're lucky."

Both Koplewicz and Hameed say that when it comes to talking about the pandemic with kids, conversations should be age-appropriate and should focus on what kids can control and what is happening in the moment, not what may or may not happen the rest of the year.

"Most children are upset by uncertainty and one of the problems we have right now in our nation is that no one is telling us what the map is," said Koplewicz. "If there is uncertainty of, 'No there is not school. Yes there is school. We have a vaccine. We don't have a vaccine. The numbers are going down. The numbers are going up,' you have to protect your child from that uncertainty."

"Parents should focus on sending main messages to kids on things like safety and really understanding hand washing and when they need to wear a mask, when they need to social distance and explaining why, and I think leave it at that," added Hameed. "Parents don't need to go into the nitty gritty details about how high the count is in their city or their state."

Koplewicz said for the sanity of both parents and kids, families can focus on what is happening week by week or even month by month.

"Let's not discuss that there's no school in person for the year," he said. "Instead, talk about how you know you're going to have to do this in September and here's how we can prepare and we can discuss at the end of the week what's going to happen next week."

6. Show your kids how you're processing emotions.

You can help your kids develop more resilient reactions to COVID-10 by leading by example, according to both Hameed and Koplewicz.

"Anxiety is very contagious, so teaching yourself how to manage your own anxiety is very important," said Koplewicz. "And being able to tell your kids that you're having a bad time and then showing them how you can get back control is important."

"It's an OK thing for parents to tell their kids, 'You're going to have to give me 20 minutes because I want to call my mom,' or, 'I want to read for 20 minutes,' or 'I want to walk for 20 minutes,' and then come back and show them how you feel," he added.

7. Be smart with screen time.

Parents can release themselves of the guilt of allowing their kids more screen time during the pandemic, recognizing that part of it is being used for socialization, according to Koplewicz.

Still, he said it is important for parents to restrict and monitor their child's screen time and break it into increments throughout the day.

"I would say, 'Now you have the time to do whatever you'd like, your free play, on the internet for the next half-hour,' and then I'd go back and say, 'And now you're going to turn it off, and you can have another half hour at eight o'clock,'" he said. "I would just be very careful about the leakage, not to let 30 minutes spill into 45 minutes or an hour."

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Kevin Dietsch/Pool/Getty ImagesBy CATERINA ANDREANO, ABC News

(WASHINGTON) -- Dr. Anthony Fauci told ABC News' Deborah Roberts that he seriously doubts the Russian-made COVID-19 vaccine, dubbed Sputnik V and touted by President Vladimir Putin, has been proven safe and effective.

Fauci, director of the National Institute of Allergy and Infectious Diseases, shared the comments exclusively with National Geographic in a virtual panel discussion hosted and moderated by Roberts. The discussion is scheduled to air Thursday at 1 p.m. ET.

"I hope that the Russians have actually, definitively proven that the vaccine is safe and effective," Fauci said. "I seriously doubt that they've done that."

Russia's health ministry approved the vaccine after only two months of trials.

Over 20 million people have been diagnosed with COVID-19 worldwide, the disease caused by the novel coronavirus, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. COVID-19 has killed more than 737,000 people globally.

In the U.S., the worst-affected country, at least 5,094,565 people have been diagnosed and at least 163,465 have died.

Putin told officials at a televised meeting that the vaccine "forms strong immunity" and that the vaccine had already been administered to his adult daughter. The Russians plan to start administering dosages to front-line workers by the end of August.

"Having a vaccine, Deborah, and proving that a vaccine is safe and effective are two different things," Fauci discussed with Roberts. He added that the U.S. is pursuing at least a dozen vaccines of its own and "if we wanted to take the chance of hurting a lot of people, or giving them something that doesn't work, we could start doing this, you know, next week if we wanted to. But that's not the way it works."

Putin said the Russian drug has "passed all necessary tests," but with just two months of trials, experts are wary about it being safe for large-scale use.

Fauci said he hasn't heard any evidence to convince him it's truly ready, and that Americans need to understand that "announcements from the Chinese or from the Russians that [they] have a vaccine" differ from those made in the U.S. "because we have a way of doing things in this country that we care about safety."

Fauci also told Roberts that how his family has been receiving death threats, and that the federal government has had to provide them with security services.

"It seems inconceivable, if you just think about it," Fauci continued, "that when you're trying to promote public health principles to save people's lives and keep them healthy ... that that's interpreted to be so far from your own way of thinking that you actually want to threaten the person. That's just no way that our society can really function well and go along that way -- we've got to get past that."

This is part of an exclusive conversation National Geographic is hosting in with Dr. Anthony Fauci, Washington, D.C., Mayor Muriel Bowser, ABC News correspondents, and experts in this month's National Geographic cover story, "How Devastating Pandemics Change Us." You can watch the free "Stopping Pandemics" event at 1 p.m. ET on Thursday by signing up at StoppingPandemics.com. The conversation is moderated by ABC News' Deborah Roberts.

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triocean/iStockBy THE GMA TEAM, ABC News

(NEW YORK) -- The stress of the coronavirus pandemic is causing people's hair to fall out in a phenomenon doctors are calling "shock hair loss."

"There's no symptoms, there's no itching, there's no pain," Dr. Shilpi Khetarpal, a dermatologist at the Cleveland Clinic, told Good Morning America. "They're just seeing more hair on the pillow on their clothes in the shower and it can be pretty distressing."

"I think as time goes on and the stress continues from this, we're going to be seeing more cases," she said.

Shock hair loss can take three to four months to appear after the onset of a stressor. Doctors say it is not an unusual condition, but with financial stress, anxiety and other emotional shocks on the rise due to the global pandemic, the stress of it all can lead to physiologic changes that push up to 50% of your hair prematurely into what is called a shedding phase.

"If you look at the life cycle of a follicle, basically think of it in three stages," said Dr. Jennifer Ashton, a board-certified OBGYN and ABC News chief medical correspondent. "There's a growing phase, a resting phase and a shedding phase. When you see a lot of shedding, that's when people perceive hair loss."

Shock hair loss is often due to psychological and emotional stress and is different than the type of hair loss that women may experience after childbirth, for example, that is due to physiologic or physical stress, according to Ashton.

Specialists say although just being emotionally or psychologically stressed out isn’t enough to cause hair loss, severe emotional stress can affect sleep, diet and overall physical health in a severe enough way that can trigger hair loss

Shock hair loss may be diagnosed through a clinical exam and perhaps lab tests or by doctors excluding inflammatory causes of hair loss, like alopecia.

There are ways to minimize the effects of excessive hair shedding, according to doctors. Everything from exercise to a well-balanced diet that is focused on protein can help, along with making sure you're getting enough iron in your diet or through supplements.

Shock hair loss also usually resolves itself after a period of time, according to Khetarpal.

"It typically lasts anywhere from three to nine months," she said. "And most of the time, in six months, it resolves on its own, and the hair does come back."

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Zerbor/iStockBy MEGAN STONE, ABC News

(NEW YORK) -- Selma Blair offered an honest update about her ongoing battle with multiple sclerosis over the weekend, revealing that she was finally able to do something she sorely missed: ride her beloved horse.

The two had an emotional reunion over the weekend, with the "Legally Blonde" actress posting two photos to Instagram. In one, she embraces her horse while sitting atop the saddle. The second is of her riding her horse over a jump.

"It is what I miss the most about my current abilities or disabilities," Blair, 48, explained in the caption. "Today, we managed to get it together to have a few minutes and I could not stop smiling."

She went on to openly detail how MS affects her body, admitting, "I can’t feel my left leg, or where my hips are. I break down and freeze when exhausted." Because of her symptoms, she asserted that she "took it slow" on her first day back on her horse.

"I am a mess with MS," the "Cruel Intentions" actress added. "But I am going to learn how to use this body, brain and emotions."

Blair made it known that, despite her limitations, she fully embraces her diagnosis.

"I will always have MS, I now see. Always," she explained, expressing her gratitude for having a wonderful trainer who has "turned nibbles into a champion babysitter for me."

Blair has now set her sights on being able to show "one day" on her horse now that she is "back in the saddle."

"Keep finding ways to do things. I have hope," she concluded. "Thank you all. Especially Celeris and Cellar Door Farm to keep encouraging me to try again, in style."

Blair was diagnosed with multiple sclerosis, a disease of the immune system that causes nerve damage, in August 2018.

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arlosDavid.org/iStockBy JACQUELINE LAUREAN YATES, ABC News

(NEW YORK) -- "Fun in the sun" feels a little different this year, but it hasn't stopped many of us from finding the perfect swimsuit for a dip in a backyard pool or a vacation in the foreseeable future.

While people search far and wide to look for options that are beach-ready every summer, finding size-inclusive picks isn't always an easy task -- especially with many fitting rooms remaining closed amid the COVID-19 pandemic.

The average American woman wears between a size 16 and a size 18, according to a study by the International Journal of Fashion Design, Technology and Education. Yet, most stores carry traditional straight sizes which range from 00-12. Fashion influencers agree that the limited options that are left make looking for swimwear even more daunting than regular clothes.

"I think that many designers are still afraid to jump on the inclusivity train," model and advocate Hunter McGrady told Good Morning America. "True inclusivity, not just going up to a size 12."

"The options just aren't really there for us," she added. "If the few sites that you love don't have something you like, you feel really defeated."

Lifestyle blogger and creator of #FatAtFashionWeek, Kellie Brown, also told GMA, "Retailers who cater to larger sizes will include swim a few times a year to help fill a void, but there are very few dedicated swim brands with truly inclusive sizing. For reference, adding two extra sizes isn't inclusive."

Though there are many brands that could use an update in their swimsuit sizing departments, there are brands such as Swimsuits For All and Chromat that are often applauded for their diverse offerings.

There are also lots of influential body-positive advocates who have figured out how to successfully shop for swimwear. GMA spoke to six of these inspirational people to get insight on how to browse through everything from beautiful bikinis to amazing one-piece looks -- no matter what body type you have.

Brown said the perfect "bikini body" is any body in a bikini. "I'd love to see the term disappear," she said. "Implying there's only one way to look to wear a bikini is ridiculous."

Before your next swimwear shopping haul, check out more tips, best practices and body-positive suggestions from six women who rock their swim looks with true confidence and allure.

Hunter McGrady
- Model, advocate and designer of All Worthy


What's your idea of the perfect "bikini body?" Every single body is a bikini body. If you have a body, you have a bikini body.

Has the fashion industry become more inclusive when it comes to swimwear offerings? I think we are very slowly getting there, but there's not nearly enough. I don't understand why every store wouldn't want to cater to every body. We are all worthy of wearing beautiful things and wearing gorgeous swimsuits; however, it isn't entirely available for us at this time.

What are any specific tips you could give to others who find it challenging to shop for swimwear? Have patience and try new things. I always thought I had to wear one certain cut and then I kept trying different styles and my taste really changed. I ended up loving the things I was trying. Society had made me believe I was only allowed to wear one style, so I encourage you to have fun with it.

What's your process like when shopping for swimsuits?
I typically go into swimsuit shopping with low expectations, and when I am surprised it is absolutely amazing. I praise companies like Swimsuits For All, Playful Promises, Eloquii, Alpine Butterfly and ASOS Curve for bringing true inclusive sizes to the forefront when it comes to swimsuit shopping.

What kind of things do you look for in your ideal swimsuit and why? Support, support, support! When I am heading to the beach or the pool I want to ensure that I am feeling supported and don't have to worry about something falling out. I want to be able to enjoy the waves or water just like anyone else.

What are some of your top three favorite swimsuits you own right now and why?


Ashley Graham x Swimsuits For All Elite Striped Ribbed Triangle Bikini: I actually wore it in this year's issue of Sports Illustrated and I felt so sexy in it.

Gabi Fresh x Swimsuits For All Vanguard Cup Sized Ribbed One Piece Swimsuit: This black one-piece is like a chic elevated one-piece. The gold hardware is so stunning.

Alpine Butterfly BFF swimsuit: I really love the girly flirtiness of this swimsuit! It is one of those ones where you could slip a high waisted skirt on after your day at the beach and head to dinner and it looks like a full look.

Kellie Brown - Lifestyle influencer and creator of #fatatfashionweek


What's your idea of the perfect "bikini body?" Any body in a bikini. I'd love to see the term disappear. Implying there's only one way to look to wear a bikini is ridiculous.

Has the fashion industry become more inclusive when it comes to swimwear offerings?
Not really. There are a few brands that I can think of who include maybe a size 14 or 16, but my mind is hard-pressed to think of straight-size brands who go beyond that.

What are any specific tips you could give to others who find it challenging to shop for swimwear?
Every human no matter their shape or size is deserving of the best beach and pool days. Be kind to yourself and pick things you like rather than trying to hide.

What's your process like when shopping for swimsuits? I'm generally looking for two categories: something sporty that I can swim laps or do aqua aerobics in [and] I also like things that make me feel really cute [like] bikinis, cool colors or interesting silhouettes. I look everywhere because there isn't one place to look. Generally, I'll order them online and keep what I like best."

What kind of things do you look for in your ideal perfect swimsuit and why?
Above all, fit. It needs to be comfortable. I prefer halters that aren't choking and ones that don't give me the feeling like I'll pop out for lap swimming. I look for swimsuits that are chlorine resistant and supportive as well.

Also, I've had a thing for white bikinis this summer.

What are some of your favorite swimsuit styles right now and why? I have a couple of crinkle bikinis. I like them because they are bright and colorful but also insanely comfortable. I also have a tie-front white bikini with a small ruffle detail that's really sweet. Another fave is from last season but it's a zip front surfer inspired color block one-piece.

Katie Sturino - Fashion influencer and founder of Megababe


What's your idea of the perfect "bikini body?" Any body is a bikini body, and I think that that's something that we're starting to come to terms with -- that "bikini body" has not necessarily been a helpful term in our society. I think the more we can talk about that and dismantle that, the more positive women will feel about their bodies.

Has the fashion industry become more inclusive when it comes to swimwear offerings? I think that people who make swimsuits have necessarily expanded fully into plus, so there's just a really limited amount of options out there still. But, there are companies out there that do it well, but they are few and far between.

What's your process like when shopping for swimsuits? I go to where I buy clothes -- so I browse stores such as Madewell which decided to expand into plus swimsuits. I like Madewell's clothes so to me that signals that maybe they figured out the fit. I also look at places like Swimsuits For All. I go to Instagram and see like, "Oh, I like that suit. She's about my size. That might fit me." That kind of thing is really where I'd start.

What kind of things do you look for in your ideal swimsuit and why? If I go to a website to specifically browse plus-size swimsuits, I will check to see if they have those swimsuits photographed on a plus model, which also means that they've invested in making appropriate plus-size swimsuits. That's a good giveaway and a signal that the company is probably going to fit me better than someone else who's tossed a 2XL on their website.

You also want support, so looking for things that have either sturdy straps or underwires or not just that one cup, like that insert that I think everyone just takes out anyway, because it ends up filling with water.

Plus-size swimsuits are also typically high-waisted and the bikinis are typically high-waisted, and I find that those are the most comfortable to wear because they really hold you in.

What are some swimsuit trends or picks you're really loving now?
I love an athletic cut top, so one that is kind of sports bra adjacent with just a high-cut brief. That's one of my favorite looks, and that's really good for body types that don't necessarily have a ton of curves. For example, I'm actually not that curvy. I'm kind of straight up and down, so I love an athletic style suit.

I also have a great one-piece that helps give me more curves and a more defined waist.

Sarah Chiwaya - Plus-size style blogger of Curvily and founder of New York City Plus


What's your idea of the perfect "bikini body?" I'm a firm believer that anyone that wants a bikini body just needs to put a bikini on. When I was younger I was too scared to wear a bikini because I thought I always had to cover up. My body hasn't gotten smaller since, but I have gotten more comfortable in my own skin and realized that confidence is something that grows when you dare to wear the thing you never thought you could.

Has the fashion industry become more inclusive when it comes to swimwear offerings? I wouldn't say the industry as a whole has become more inclusive -- even some of the handful of brands that are expanding sizing in their clothes aren't doing so for swimwear, but there are definitely far more options today than even five years ago.

Plus-size swimsuits used to be almost uniformly black, skirted tankinis emphasizing control panels and "slimming" coverage. Now, more and more brands are realizing that the majority of American women want fun, on-trend swim options just like straight-size women do, and are stepping up to meet that demand.

What are any specific tips you could give to others who find it challenging to shop for swimwear? Find bloggers and influencers that have a similar body type to help you get an idea of what suits will look like on you. Representation matters so much, so you will feel more confident when you order -- and hopefully get practical tips for shopping, too. On my own Instagram, I have a regular try-on series called #inthefittingroom where I get into the fit and sizing details of everything I try on, and my readers say it is really useful for helping them order the right size, especially from new companies they weren't familiar with before.

What's your process like when shopping for swimsuits? I get most of my swimwear inspiration from other plus-size bloggers on social, which is also where I find most of my cute, fashionable swimwear in plus sizes. I love finding new independent swimwear brands to shop, and also keep an eye out for influencer collabs from some of the big swim sites. The GabiFresh for Swimsuits For All collection is a perennial fave of mine.

What kind of things do you look for in your ideal swimsuit and why? As with clothes in general, I'm all about dressing for my swim mood. So my bathing suit wardrobe has everything from strappy animal print numbers that are more suited to poolside lounging to more substantial one-pieces that are perfect for jumping around in the waves.

From a practical standpoint, my perfect swimsuit has sufficient room and support in the bust so I feel secure that I'm not in danger of a wardrobe malfunction.

What are some of your top three favorite swimsuits you own right now and why? This is a hard question because I have so many that I love. I think my current favorites are my classic string bikini from Curvy Beach, my long sleeve cutout suit from Chromat and my high-waisted BFF suit from Alpine Butterfly.

Nicole Simone - Fashion influencer behind Curves on a Budget


What's your idea of the perfect "bikini body?" It's cliché, but a body in a bikini. Bikinis on every body type need to be normalized.

Has the fashion industry become more inclusive when it comes to swimwear offerings?
I think actual plus brands maintain consistent inclusivity, however most brands still only go up to a size 18 or offer extended sizes up to a 20. Also, I can only name maybe four places I can go walk into right now and try on a swimsuit before I buy it. So no, I don't think there's more true inclusivity, just brands expanding their size range just enough to say they carry plus.

What are any specific tips you could give to others who find it challenging to shop for swimwear?
Know your measurements! Especially now, since going out to a store may not be an option for most and since sizing is different from brand to brand. Also, go into it excited. You deserve cute and trendy swimwear. You are worthy enough to wear any suit you please

What's your process is like when shopping for swimsuits?
When I shop for swimsuits it's almost always online. It's very rare that I have the option to try anything on before I buy it. None of the models look like me physically so it's important that I know my measurements. That's how I decide if it's going to fit me properly.

What kind of things do you look for in your ideal perfect swimsuit and why?
I love cut-outs and anything with underwire. Cutouts are just really fun and an easy way to show skin without showing all the skin if that makes sense. I'm a DD and as cute as strappy halter tops are, this girl and her girls need support.

What are some of your top three favorite swimsuits you own right now and why? My top three are a black cutout suit from the Gabi Fresh Collection from swimsuits for all, a white Ashely Graham bikini -- it was my first teeny bikini ever and I'll never get rid of it. Also, this blue tie-dye bikini from Shein because I'm obsessed with that trend right now.

Allison Kimmey - Plus-size influencer and self-love expert


What's your idea of the perfect "bikini body?" My idea of the perfect bikini body is any body. If you have a body and you put a bikini on it, you have a bikini body. Its the perfect bikini body because it's your bikini body and no one else has your exact body, with your exact experiences in your body.

Has the fashion industry become more inclusive when it comes to swimwear offerings? Relatively speaking, yes I think that the fashion industry has taken some steps to become more inclusive. However, I still can only walk into a handful of stores and actually try on a swimsuit. But, there are more brands that enter the space and try to answer that void every year, which is exciting.

However, I still see that the sizing options don't normally extend past a 2x or size 18/20 which is certainly not size inclusive of all bodies. I'd love to start seeing 4x, 5x, 6x offerings. Some brands are finally getting that just because we may need a larger size, doesn't mean we want to cover up every inch of our bodies -- we want to show them off.

What are any specific tips you could give to others who find it challenging to shop for swimwear? Always start with a pep talk, be your own hype woman, or bring someone who can be that for you. That internal dialogue can have you leaving a store with nothing because you've talked yourself out of wearing that bikini. You can wear anything when you want and the first thing you have to put on is your confidence.

I love looking at some of my favorite influencers on Instagram to see what swimsuits they are wearing. Find someone that is a similar size and body shape to you -- it's very inspirational to see other women wearing things you might not normally wear to give you ideas and some confidence to try it yourself.

Try things that are outside your comfort zone. If you see it and your initial reaction is, "Oooh! I like that," then try it.

What's your process is like when shopping for swimsuits?
My personal swimwear shopping process starts with a pep talk, and yours should too. Trying on swimwear can be really triggering and leave you feeling less than confident about your body. I like to remind myself that I am worthy of wearing whatever I want and that I should choose whatever I like best, not what I think others will feel most comfortable with.

I also prefer online shopping for swimwear because I am not a fan of dressing rooms -- there's terrible lighting plus tiny spaces which equals a nightmare for me. I love being in my own home, where I have time to try on the pieces, walk around, and see how they make me feel.

What kind of things do you look for in your ideal swimsuit and why? I always go straight for the two-pieces as I love that there is so much versatility in fit and mix/match combinations. The first thing that usually draws my attention is the color or pattern, I love bold and bright colors and I am not afraid to mix patterns.

The next thing I usually look for is dependent on what I need for that particular suit. That might sound funny, but there are different types of swimwear for different activities, and being a Florida beach gal, I have a swimsuit for anything: I have classy, modest one-pieces, full coverage and supportive sporty suits or cheeky sets for when it's just me and the hubby.

Other things to consider are how much support you need either in the bust or tummy.

What are some of your top three favorite swimsuits you own right now and why? When choosing my top three bathing suits, it was very difficult since I own over 75 bathing suits, but here are some of my different bathing suit "personalities."

One of my favorite fairly size-inclusive brands is Summersalt, and my favorite suit right now is the Ruffle Sidestroke. I love how you can easily go from day to night without skipping a beat in these trendy and classy one-pieces.

My next favorite bikinis are from one of my tried and true brands, Swimsuits for All. They have been making suits in sizes 8-24/26 for a very long time, and they do it really well. Swimsuits for All has a very wide selection of styles, from cheekier bikinis to full coverage swim dresses, you can find anything you're looking for there!

Aerie has affordable mix-and-match pieces. The high-cut high-rise bikini bottom is my most comfortable and favorite bottoms. All their patterns are super fun and easy to mix with other tops and bottoms. They are always launching new collections all the time.

Editor's Note: Interviews have been edited and condensed for clarity and conciseness.


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Emma Fischer/Duke UniversityBy ANGELINE JANE BERNABE and SARAH MESSER, ABC News

(NEW YORK) -- As over 20 million across the globe have been diagnosed with COVID-19, scientists from Duke University took a look at face masks to see which ones work best in slowing the spread of coronavirus.

In their study, they looked at 14 masks including N-95s, N-95s with valves and surgical masks to see how effective each was in keeping droplets from getting out.

“It was mainly focused on the technique, a simple technique to visualize these droplet emissions and the effects of masks,” said Dr. Martin Fisher, an associate research professor from Duke University.

While they found that not all masks are created equal, the experiment confirmed that most face covers cut down the transmission of those droplets.

Here’s their ranking on six of the 14 masks researchers tested:

The fitted N95

Duke University researchers found that fitted N95 masks, which have a sealed fit around the wearer’s mouth protects the wearer and others around them well.

Surgical masks

According to the study, disposable surgical masks (nonwoven, 3-layer) may seem flimsy, but they are engineered to catch droplets. Doctors say that if you want to be extra safe, add a face shield on top of the surgical mask, which is what they do when they aren’t dealing with a high risk COVID case.

Cotton/polyester masks

Researchers found that cotton and polyester masks are a hit or miss. While wearing one will protect you, experts say that more layers are generally better, especially if they are a combination of different materials in different layers (cotton/polypro blend). And what’s really important is how well it fits and whether there are big gaps.

Valved masks

Last week, valved masks were banned from several airlines, and rightfully so. According to the study, researchers found that valved N95 masks were significantly worse than fitted, non-valved N95 masks for preventing the spread of droplets.

“It protects you, the wearer, but it doesn’t protect other people if by chance you have the disease and you don’t know, ” said Dr. Eric Westman, an associate professor of medicine at Duke University. “We were very surprised to see how many particles came out of the valve.”

Bandanas

While many have been using bandanas as a face mask alternative, researchers found that it offers very little protection.

Neck gaiters

Just like bandanas, these popular and fashionable face coverings among runners prior to the pandemic, don’t provide much protection.

Gaiters, which are known for being made of fleece, were found to release a lot of little particles from the wearer and created more tiny droplets than speaking without a mask.

“This mask breaking down big droplets into you, multiple little droplets,” said Fisher. “These little droplets could be problematic because they have an easier time being carried away by air. So they might travel for the distance as opposed to just dropping down to the floor. So this was problematic.”

So what’s important to think about when picking a mask? Experts say the key is to pick one that you will wear -- one that fits snugly and one that you will keep on and not fidget with. Above all, they say that any mask is better than no mask.

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HRAUN/iStockBy DR. L. NEDDA DASTMALCHI, ABC News

(NEW YORK) -- Since the novel coronavirus caught the world's attention in December 2019, doctors have been trying to determine how the virus damages the body -- and trying innovative treatments to stop it in its tracks. Now, they may have found one solution for treating COVID-19 patients in critical condition.

Some of the most serious cases of COVID-19 require long periods of time in the intensive care unit, on ventilators. Out of options, a group of doctors at Northwell Health's North Shore University in Manhasset, New York, took a step back and wondered if they could stop the virus from causing further damage by introducing freezing temperatures.

"We had exhausted all therapies," Dr. Hugh Cassiere, the director of critical care services at Sandra Atlas Bass Heart Hospital at North Shore University, told ABC News. "We wanted to find a solution to be able to rest the lungs and the body, and thought of the process of cooling the body."

Doctors say when patients are critically ill, and require mechanical ventilation, the elevated metabolism can break down the muscles used in breathing, leading to difficulty in patients coming off invasive ventilation. The high levels of carbon dioxide, the low levels of oxygen, and highly acidic blood creates the perfect storm for organs to fail.

While sick in the ICU with COVID-19, a patient's body may look like it is resting, but there may be an increase of energy being used as a result of high fevers, a hyper-inflammatory response, or cytokine storms. This is called the hypermetabolic response.

The premise of targeting the hypermetabolic rate is to prevent the body from using so much energy, such as oxygen, which can cause muscle breakdown and make ill patients weak and frail.

"Lowering the body temperature has been shown to decrease the metabolic rate, which is why we chose to use this therapy," Cassiere told ABC News. He further explained that these lower temperatures slow down the chemical reactions in the body that can potentially turn fatal.

The group introduced the cooling down procedure to four critically ill patients -- who were out of other options and were believed to be close to death -- for 48 hours. They found that therapeutic hypothermia decreased hypermetabolic states caused by COVID-19 and improved lung function in two of the patients who had severe infections with multi-organ failure. The doctors published their experimental results in Metabolism Open, a peer-reviewed, open-access journal that publishes original research.

The four critically ill patients were given one more chance to fight the virus with the therapeutic hypothermia. They were cooled to 34.5 degrees Celsius (94.1 degrees Fahrenheit) for 48 hours. All four patients were calculated to have reduced metabolic activity and improved oxygen levels in their blood.

Two of the four patients -- who had exhausted therapies available to them and were thought to have lost the battle against the novel coronavirus -- were successfully taken off mechanical ventilation after the treatment.

"These patients would have died without the hypothermia," Cassiere told ABC News. The team had planned to see if they could get patients off mechanical ventilation, but instead they had better results: survival.

"We were seeing that these patients with COVID-19 were dying from organ dysfunction because they were unable to remove these high levels of carbon dioxide being produced," said Dr. Pey-Jen Yu, a cardiac surgeon and the surgical director of clinical research at Sandra Atlas Bass Heart Hospital at North Shore University Hospital, who was also the lead author of the paper.

The team involved in the paper was seeing other supportive measures, such as extracorporeal membrane oxygenation (ECMO) and mechanical ventilators, fail in supporting lung function and suppressing the high levels of carbon dioxide in patients' blood.

"When you have acid in the bloodstream all the normal body functions start to shut down and severe psychosis leads to multi organ system dysfunction and can lead to death," Cassiere said. "The reason we want to highlight that is because [in] some of our most challenging patients with ventilator management [death] isn't [caused] because of oxygen problems, the carbon dioxide and the acid in the blood are the issue. It's all connected."

Yu said that therapeutic cold temperatures are not new. During cardiac surgeries, she uses therapeutic hypothermia to decrease the metabolic rate to preserve organ vitality. Therapeutic hypothermia is also used after cardiac arrest; studies have shown that dropping the body temperature to 32-36 degrees Celsius for 24 hours helps preserve brain function.

Prior to starting the therapy on these patients, Cassiere informed ABC News that he and his team first found the longest duration of time the human body could tolerate hypothermia. He also said they used 34.5 degrees Celsius as it was the most common temperature used in established protocols, such as for cardiac arrest.

Therapeutic hypothermia doesn't stand without risks, explained Dr. Viren Kaul, a pulmonary critical care specialist at Crouse Health and an assistant professor of medicine at SUNY Upstate Medical University. When cooled, he said, patients have the risk of developing arrhythmias, increased bleeding and electrolyte abnormalities. More concerning are the complications that can occur during the rewarming phase if done too quickly: brain swelling, dangerously high potassium levels and seizures.

Although this paper presents a novel idea to help suppress the damage caused by COVID-19, Kaul warned that improved numbers (regarding metabolic status) do not always translate to survival. The medical community needs to understand what this means for patients and the public.

Despite the uncertainty, Kaul said he is excited to see more research on using hypothermia as a supportive measure for COVID-19. If patients are living after severe SARS-CoV-2 infections, then Kaul would like to know at which point during the infection patients would benefit from therapeutic hypothermia.

Fortunately for Kaul and doctors still on the front lines of the COVID-19 pandemic, Yu and Cassiere's research team was recently approved by the Feinstein Institute to actively enroll patients to further study therapeutic hypothermia and its effects on the coronavirus.

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iStock/designer491BY: ESTHER CASTILLEGI and ALLIE YANG

(NEW YORK) -- Dr. Anthony Fauci told “World News Tonight” anchor David Muir that if mask and social distancing guidelines aren’t followed, the U.S. could be dealing with dual outbreaks of the flu and COVID-19 come fall and winter.

Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said in July that the convergence could create “one of the most difficult times that we've experienced in American public health" during a webinar for the Journal of the American Medical Association.

"I totally agree," said Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), who has advised six U.S. presidents. He noted that if masks and social distancing is not enforced “in a uniform way” Redfield’s prediction may become a reality.

“We'd have a convergence of two respiratory diseases,” he said during an interview Monday. “We can have a very difficult time.”

“I want to impress upon the American people in a way that's so clear: There are things that we can do that would get the level down,” he said. “If we go into the fall and the winter, David, with the same situation… we will have upticks of percent positive, and then you have the inevitable surging of infection.”

There is a way the convergence can be avoided, Fauci says, “but it’s not by wishful thinking.”

Fauci previously named a goal of less than 10,000 cases a day by the fall. The U.S. is still seeing 50,000 to 70,000 cases a day, according to the World Health Organization.

“The way human nature is acting out there, it doesn't seem likely [this goal will be met]. But that doesn't mean it can't be done,” Fauci said. “I don't know howmore forcefully I can make that plea to the American people. That we can open the country, we can get back to normality, if we do some simple things.”

He said he isn’t pessimistic that the country can pull together and bring COVID-19 cases down.

“My message is one of cautious optimism and hope,” he said. “But I'm also very realistic to know that if we don't do it, we’re going to continue to have this up and down.”

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