Health News

CDC warns loosely woven cloth masks are 'least protective' against COVID


(ATLANTA) -- Any mask is better than no mask. But loosely woven cloth masks provide the least amount of protection and Americans in some cases might want to opt for higher quality masks like KN95 and N95 respirators, the Centers for Disease Control and Prevention wrote Friday in updated online guidance.

"Wearing a highly protective mask or respirator may be most important for certain higher risk situations, or by some people at increased risk for severe disease," the CDC stated.

The updated guidance comes after weeks of health experts urging Americans to upgrade their masks in the face of omicron, warning that cloth masks are not effective enough at stopping the highly transmissible variant from spreading.

But with much of the public reluctant to wear a mask at all, the CDC recommendation stops short of calling on Americans to choose one mask over the other, maintaining that any mask is better than no mask. The CDC also argues that higher quality masks can be less comfortable, and if a person takes it off, they are left with no protection.

"What I will say is the best mask that you can wear is the one that you will wear and the one you can keep on all day long that you can tolerate in public indoor settings and tolerate where you need to wear it," Dr. Rochelle Walensky, the CDC director, told reporters this week.

N95 and K95 masks can be costly and harder to find, even as the U.S. government has built up a stockpile of 737 million N95s to ensure first responders don't fun out. President Joe Biden said this week he is developing a plan to make the higher quality masks more widely available.

"Next week we'll announce how we're making high-quality masks available to the American people for free," Biden said.

In its earlier guidance, the CDC urged Americans not to purchase surgical N95 masks so as to save them for health care workers. However, it noted that "basic disposable" respirators can be an option so long as supplies are available.

While this latest guidance stops short of calling on people to wear a certain type of mask, it includes more information about why a person might opt for a nonsurgical N95 or a KN95. It also suggests wearing a disposable surgical mask with a cloth mask over it to improve the fit.

"Some masks and respirators offer higher levels of protection than others, and some may be harder to tolerate or wear consistently than others," the CDC stated in the updated guidance. "It is most important to wear a well-fitted mask or respirator correctly that is comfortable for you and that provides good protection."

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Debunking the idea viruses always evolve to become less virulent

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(NEW YORK) -- As evidence mounts that the omicron variant is less deadly than prior COVID-19 strains, one oft-cited explanation is that viruses always evolve to become less virulent over time.

The problem, experts say, is that this theory has been soundly debunked.

The idea that infections tend to become less lethal over time was first proposed by notable bacteriologist Dr. Theobald Smith in the late 1800s. His theory about pathogen evolution was later dubbed the "law of declining virulence."

Simple and elegant, Smith's theory was that to ensure their own survival, pathogens evolve to stop killing their human hosts. Instead, they create only a mild infection, allowing people to walk around, spreading the virus further afield. Good for the virus, and, arguably, good for us.

But over the past 100 years, virologists have learned that virus evolution is more chaotic. Virus evolution is a game of chance, and less about grand design.

In some cases, viruses evolve to become more virulent.

Continued virus survival, spread and virulence are all about the evolutionary pressures of multiple factors, including the number of people available to infect, how long humans live after infection, the immune system response and time between infection and symptom onset.

Unfortunately, that means it's nearly impossible to predict the future of the pandemic, because viruses don't always evolve in a predictable pattern.

There have been thousands of identified COVID variants, each with unique mutations. But most new variants emerge and then quickly die out, unable to compete with the reigning dominant variant.

Some variants, however, have clear "advantages to continued survival, such as those that evade the immune system and spread easily," said Dr. Abir Hussein, associate medical director for infection presentation and control at University of Washington Medical Center.

Experts warn that it is important to assess the severity of omicron in the context of existing immunity through vaccines and prior infections.

"It is difficult to determine with new variants like delta and omicron if variants are evolving to be more or less virulent. This is because these variants emerged at a time when we had a good deal of immunity to SARS-CoV-2 in certain countries," said Andrew Pekosz, a professor of microbiology at Johns Hopkins University Bloomberg School of Public Health.

People who are vaccinated or recently infected will have milder symptoms if they experience a breakthrough infection or a reinfection, studies show.

"This is not because the variant is less virulent, but because your immune system was primed from prior vaccination and infection," said Pekosz.

Experts say omicron should not be taken lightly or thought of as a less lethal form of COVID. Even if less deadly, the omicron variant is also significantly more transmissible, leading to more deaths overall.

The U.S. Centers for Disease Control and Prevention predict that 22,000 more people could die of COVID-19 over the next two weeks.

People who are unvaccinated remain significantly more at-risk, with officials estimating they are 17 times more likely to be hospitalized and 20 times more likely to die of COVID-19 compared to people who are vaccinated.

"The available COVID vaccines provide immunity for a range of variants and continue to be the first line of defense," said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital and an ABC News contributor.

As for the future of the pandemic, experts say new variants may emerge in the future, but they won't be easy to predict.

Jess Dawson, M.D., a masters of public health candidate at Johns Hopkins Bloomberg School of Public Health, is a contributor to the ABC News Medical Unit.

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High school sports feel impact of omicron surge, from paused games to mask mandates

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(NEW YORK) -- High school athletics are feeling the impact of the omicron surge, from paused games to restricted fans, amid a winter season that coaches and administrators already anticipated would pose challenges for indoor, close-contact sports.

Amid record COVID-19 cases in the U.S., schools are revisiting coronavirus protocols and guidelines to safely keep students playing in person. Teams have had to limit out-of-state travel due to transmission risks, or postpone in-league games due to cases. The Los Angeles school district, the second largest in the country, returned from winter break in person this week with a pause on all sports competitions due to surging cases.

Despite omicron, school officials are optimistic districts won't experience the same level of disruption as last school year -- when some programs saw abbreviated seasons, if any at all -- thanks to measures like vaccination and social distancing.

"It has not risen to the level that high school sports across the nation are being disrupted to the point where they can't go on," Karissa Niehoff, executive director of the National Federation of State High School Associations, the national leadership organization for high school sports and performing arts activities, told ABC News. "There's never been an expressed need for shutdown because people know how to deal with it now."

Readjusting schedules and protocols

Before the Los Angeles Unified School District returned to the classroom Tuesday following winter break, more than 65,000 public school staff and students had tested positive for COVID-19, for a positivity rate over 14%, according to district data. The school district temporarily paused all athletic competitions this week as it monitors cases, with student athletes allowed to practice outdoors while wearing a mask.

The district is also using this week to upgrade its health and safety protocols to be in compliance with stricter protocols from the county health department. Teams with four or more linked cases over a 14-day period are now required to suspend activities for a week.

"We will reevaluate our data and determine next steps before the end of the week," the district said in a letter sent to families. "Our goal is to resume athletic competitions as soon as possible."

As of Wednesday, the district did not have an update on its plans, a Los Angeles Unified spokesperson told ABC News.

Other entities have revised protocols amid the surge. In Washington state, all athletes and team personnel in high-risk sports are required to have regular COVID-19 testing regardless of vaccination status "in response to recent sports-related outbreaks," health officials said. Testing frequency was also increased to three times weekly. Previously, schools were testing unvaccinated students twice a week.

The revised rules came after the state health department traced 200 COVID-19 cases to multiple wrestling tournaments in early December.

In Portland, Oregon, the school district made several changes to its COVID-19 protocols through at least early February to help stem the spread of the virus, including requirements that student-athletes wear masks at all times. For competitions, spectators ages 5 and up also now must show proof of being fully vaccinated or a negative COVID-19 test within 72 hours.

Some schools have recently restricted the number of fans who can be in attendance. In Oahu, spectators are not allowed until further notice "based on the rising number of COVID-19 cases," the Hawaiian island's school sports association said.

In Fairfax County, Virginia, school officials are limiting crowds to just family members through Jan. 21 due to the uptick in cases in the community.

"The health department had anticipated the surge, and we've taken appropriate measures to try to limit as much of an impact as far as the spread of the virus," Bill Curran, director of athletic programs for Fairfax County Public Schools, told ABC News.

Successes and challenges

Mitigation strategies have helped keep sports in play with only minor disruptions this year, Niehoff said. The measures have included protocols "big and small," from widespread vaccination efforts to having multiple, sanitized basketballs at the ready during games, digital ticketing and concessions and frequent communication when potential postponements arise.

"If you've got a healthy school and then a school that can't play, the healthy school goes and finds another healthy school and we get the game on," she said. "We've been creative and supportive and a little safer, because we have a better idea of what we're dealing with."

Schools have gotten accustomed to being flexible during the pandemic, though it's not without its challenges.

In New York City, sports programs this school year have had to react to evolving protocols around vaccination requirements, spectators and travel while seasons were about to start or underway.

For Shawn Mark, head coach of the South Shore boys' basketball team in Brooklyn, limits on traveling to competitions outside the city have "hurt us."

"To be the best you got to play against the best," Mark told ABC News. "Sometimes it's not always in New York City, you got to go out of town."

All athletes in the New York City public school system -- the largest in the nation -- are required to be vaccinated in order to play.

The city's public school enrollment has also dropped by about 17,000 students this year, according to preliminary data -- posing another challenge as athletes have left the public school system or the city altogether, Mark said.

"They want to play, they don't want any risk of what happened before, where a shutdown happens and then, you know, the season's over," he said.

Despite a couple postponements, Mark is optimistic that this season will continue.

Niehoff doesn't expect schools to see the same level of disruption as last school year, as long as states and districts continue to exercise caution and vaccination numbers trend up.

"We are hearing a success story, obviously concerns as they arise, but they tend to be remediated pretty quickly," Niehoff said.

Curran is "cautiously optimistic" as cases appear to be quieting down. After playing abbreviated schedules last school year, the school district has returned to its regular sports seasons.

"We are able to offer our program in a pretty meaningful way," Curran said, noting that the impact on students' overall health and well-being has been "phenomenal." "We've seen some cancellations of games here and there throughout, but for the most part we've been able to keep things moving."

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Gay men still face hurdles to donate blood amid national shortage

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(NEW YORK) -- The U.S. is facing a national blood crisis, the "worst blood shortage in over a decade," the American Red Cross warns. Despite this urgent need for donations, people who have sex with gay or bisexual men are still facing restrictions on their ability to give blood.

The Food and Drug Administration bars people who have had sex with gay or bisexual men from donating blood for three months following the most recent sexual contact because of fears of HIV in the blood supply.

The agency changed the deferral period from 12 months to three months in November 2020 as blood donations fell and hospitals faced critical shortages during the first year of the COVID-19 pandemic.

Some advocates, including the HRC, say the FDA is moving too slowly on removing the restriction, saying that it's an outright ban on the ability of people, particularly gay and bisexual men, to donate blood.

"Just like other individuals throughout the country, many people have sex on a regular basis, including with partners and spouses," said Sarah McBride, the press secretary of the LGBTQ advocacy organization the Human Rights Campaign.

"It really amounts to being an effective ban, based on a person's identity rather than an actual factor on the science," she added.

In 2015, the guidance changed from a lifetime ban to a 12-month deferral, and the FDA determines the guidance used by all U.S. blood collection organizations.

Restrictions on blood donations from gay and bisexual men, who are considered to be at high risk for HIV or AIDS transmission, date back to the 1980s.

Gay and bisexual men undergo individual risk assessments instead of time-based bans in countries around the world, recently including Greece and France, according to international reports. Italy, Israel, and several other countries have similar requirements.

In 2020, ABC News broke the story that several major blood donation organizations -- including the American Red Cross, Vitalant, and OneBlood -- announced that they are working together to study and provide data to the FDA to determine if eligibility based on an individual’s risk can replace the current time-based deferral system while maintaining the safety of the blood supply.

Vitalant told ABC News in a new statement that researchers are halfway toward its goal of enrolling 2,000 participants across eight cities: Washington D.C., San Francisco, Orlando, New Orleans/Baton Rouge, Miami, Memphis, Los Angeles, and Atlanta. They encourage gay and bisexual men who are 18 to 39 years old to participate in the research.

The FDA, in a statement to ABC News, said that this study could generate data that will help the agency determine if a donor's individual risk assessment and questionnaire would be just as effective in reducing the risk of HIV in the blood supply as the time-based deferrals the FDA already has in place.

The FDA also said it does not have a specific timeline for when these studies will be completed but that it is "committed to gathering the scientific data that can support alternative donor deferral policies that maintain a high level of blood safety."

The America Red Cross said that there is no clear data that would suggest that changing this blood donation policy would significantly increase the number of blood donations, but the organization says it does not intend to discriminate against the LGBTQ community.

"We believe blood donation eligibility should not be determined by methods that are based upon sexual orientation and we’re committed to achieving this goal," the American Red Cross said in a statement to ABC News.

However, according to the organization, doctors are now being forced to decide which patients receive blood transfusions and who is forced to wait due to the shortage. The organization says that "a lack of blood and platelet donations are critically needed to help prevent further delays in vital medical treatments."

"Donors who are excluded solely on their membership in a group ... doesn't encourage safe sexual behaviors in the integrity of the population," McBride, from HRC, said. "We want people to be engaged in safe sex practices. And we want to ensure that our blood supply is safe and sufficient."

ABC News' Tony Morrison contributed to this report.

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Study finds COVID-19 may increase risk of diabetes in kids: 3 things for parents to know

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(NEW YORK) -- Kids who have recovered from COVID-19 may have an increased risk of developing diabetes, according to a new study from the Centers for Disease Control and Prevention.

The study, which looked at databases with information for over 2.5 million patients under 18, found that children diagnosed with COVID-19 were about 2.5 times more likely to receive a new diabetes diagnosis a month or more after infection.

The health care data, taken from the first full year of the coronavirus pandemic, showed that other, non-COVID-related infections were not found to be associated with increased risk of diabetes diagnosis, leading researchers to look for reasons for this possible link between COVID and diabetes diagnoses.

A possible link between COVID-19 and an increased risk of diabetes has also been found in adults. In June, two studies were released that showed the virus’s ability to infect pancreatic beta cells, decrease insulin secretion and effectively yield Type 1 diabetes.

In Type 1 diabetes, the body completely stops making insulin, requiring daily insulin injections, via shots or an insulin pump, to stay alive.

In Type 2 diabetes, the body continues to make insulin but develops insulin resistance, meaning the cells do not respond to insulin correctly.

The CDC's new study on children ages 18 and under, released Friday, included cases of both Type 1 and Type 2 diabetes in its analysis.

The new concern for kids comes as the United States continues to see its most significant COVID-19 infection surge yet, which is heavily impacting children.

Last week alone, 580,000 children tested positive for COVID-19, nearly three times more than two weeks prior, according to a weekly report from the American Academy of Pediatrics and the Children’s Hospital Association.

Here are three things for parents to know about kids, COVID-19 and diabetes.

1. Not all kids with COVID will get diabetes.

Sanjoy Dutta, Ph.D., vice president of research for the Juvenile Diabetes Research Foundation, a nonprofit organization focused on Type 1 diabetes research and advocacy, said parents should be aware that the new research shows an association between COVID-19 and diabetes, but does not identify how the virus could or whether it actually does increase the risk of diabetes in kids.

"I would not necessarily go about raising the alarm bell right now that it is increasing Type 1 diabetes," said Dutta. "There is no mechanism yet to suggest that it is doing it or how it is doing it."

The study did not include information about who may have had preexisting conditions that could lead to diabetes and did not include laboratory data confirming the new diagnoses.

The study also did not include people without commercial health insurance, which excludes over one-third of children in the U.S.

2. Getting vaccinated remains important.

The study's findings highlight the importance of getting vaccinated against COVID-19, according to the CDC.

Currently, all children ages 5 and older are eligible to receive the Pfizer vaccine. Children ages 12 and older, and certain immunocompromised children ages 5 to 11, are also now eligible to receive a third dose of the Pfizer vaccine.

Pediatricians say the safety of the vaccine is far more proven than the uncertainty of potential complications from COVID-19 for kids.

"We have never had a vaccine that we've ever given, going back 100 years, that long-term suddenly something showed up that didn't show up within the first two to three or four months," Dr. Stanley Spinner, chief medical officer and vice president of Texas Children's Pediatrics and Texas Children's Urgent Care, told ABC News earlier this month. "So we are very comfortable about the safety long-term of these vaccines."

"What we don't know is what the long-term effects of COVID can be to kids, even when they get over it now," he continued. "Parents need to know that if your child gets COVID and seems to be OK with it, great, but what's going to happen maybe six months or a year or five years down the road, because we definitely don't know."

3. There are warning signs of diabetes to look for.

The CDC is urging parents, pediatricians and caregivers to be aware of the warning signs of diabetes.

Symptoms of diabetes include thirst, hunger, frequent urination, unexplained weight loss, blurry vision and fatigue, according to the CDC.

Dutta added that parents should watch for unusual behavior patterns in their kids.

"Any unusual pattern of change in behavior in a short window of time is what I would look out for as a sign of needing to consult a doctor," he said. "It's not intentional, but it's very easy to overlook some of the signs of a disease."

Concerned parents should contact their child's medical provider, or in the case of an emergency, seek immediate help. A delay in diagnosis can lead to diabetic ketoacidosis, a serious complication of diabetes that can be life-threatening, according to Dutta.

A diabetes diagnosis can typically be made through a blood test.

ABC News' Sony Salzman and Robert Rowe, a resident in the ABC News Medical Unit, contributed to this report.

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CDC to weigh in soon on whether Americans should upgrade their masks

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(ATLANTA) -- After weeks of health experts urging Americans to upgrade their masks to protect against the omicron COVID-19 variant, the Centers for Disease Control and Prevention said Wednesday that it was planning to update its mask guidance to "best reflect the multiple options available to people and the different levels of protection they provide."

In a statement provided to ABC News on Wednesday, the agency said the goal is for Americans to have "the best and most updated information to choose what mask is right for them."

The move by the CDC would be the first significant update to its mask guidance since last July when it urged all Americans to return to wearing masks, after the delta variant proved so transmissible that research found even vaccinated people could transmit the virus.

While vaccinated people are considered infectious for a shorter period of time than someone who is unvaccinated, and they are considerably less likely to end up hospitalized, the CDC urged everyone to return to masking indoors to prevent community cases from rising.

Since the arrival of omicron, however, health experts have urged caution with the usual cloth masks and cities like Los Angeles and New York have already recommended mask upgrades to their residents.

CDC would not say how soon it planned to update its online guidance, although one administration official said the goal was by week’s end. The Washington Post first reported that CDC was considering the update to its guidance.

Dr. Rochelle Walensky, the agency's director, told reporters on Wednesday that the overall recommendation won't change that "any mask is better than no mask" and that a mask should fit well.

The best mask, she told reporters, is "the one you can keep on all day long that you can tolerate in public indoor settings and tolerate where you need to wear it," Walensky said.

"I recommend you get the highest quality mask that you can tolerate and that's available to you," Dr. Anthony Fauci, the nation's top infectious disease expert and President Joe Biden's senior medical adviser, told CNN on Tuesday.

One problem with pushing higher grade masks is that they can be costly, harder to find and – in the case of surgical N95s – somewhat uncomfortable to wear. The CDC also warns customers against counterfeit masks that aren't as effective.

Prior to omicron, Walensky resisted a call for Americans to wear surgical N95 masks for the average American because the agency didn’t want to discourage people from wearing any mask.

Walensky did not wear an N95 mask while testifying on Capitol Hill Tuesday. According to a spokesperson, she wore a disposable mask with a cloth mask on top "to ensure a tight seal." That would be in keeping with CDC's current guidance that suggests Americans could opt for two masks for increased protection.

To address the issue of limited supply, the Biden administration says it’s planning to help ramp up production of N95s to make them more available to Americans who want one. Dawn O’Connell, a top official at the Health and Human Services Department, said Tuesday that the government planned to sign a contract within the next month or so that would identify a provider to produce 140 million N95 masks a month.

There are already 737 million N95 masks in the strategic national stockpile available for medical workers.

White House COVID Coordinator Jeff Zients said Wednesday the White House was seriously considering making "high quality masks" available to all Americans, although he did not provide additional details.

ABC News reporter Cheyenne Haslett contributed to this report.

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Nearly 2 million cases of cancer likely to be diagnosed in 2022: Report

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(NEW YORK) -- Nearly 2 million new cases of cancer are expected to be diagnosed and some 609,000 people will likely die from cancer in the U.S. in 2022, according to a new report published Wednesday.

The annual report from the American Cancer Society estimates that 1,918,030 Americans will be diagnosed with cancer, equivalent to 5,250 new cases being detected every day. This is up from approximately 1.8 million new cases that likely occurred in 2021.

Both figures -- for cases and deaths -- are the highest estimates made by the ACS since at least 2007.

Health experts have suggested that people missing cancer screenings and doctor's appointments due to the COVID-19 pandemic may cause cancer rates to rise in the coming years.

However, Dr. Rebecca Siegel, an epidemiologist at the American Cancer Society and corresponding author of the report, told ABC News that estimates were made based on complete data, which is only available through 2018 for cases and 2019 for deaths.

"We absolutely expect that the pandemic will impact cancer rates because of delays in screenings, and diagnoses because of health care closures, but we were not able to account for that yet," she said.

She expects future reports will likely reflect the impacts of the pandemic.

Among the findings in the report is that cases of breast cancer have been slowly increasing by about 0.5% every year. In 2022, an estimated 290,560 Americans will be diagnosed with breast cancer, mostly women.

Siegel said this is not because of an increase in screenings that detect the cancer but rather because more women are having fewer children later in life -- both of which are linked to an increased likelihood of breast cancer.

"It's thought to be related to continued declines in the fertility rate, because the higher number of childbirths and the earlier age is protective against breast cancer, and we know that women are having children later and they're having fewer children," she said. "So that is likely contributing to this small increase."

She added that higher body weight also increases the risk of breast cancer and that increasing rates of obesity are likely a contributing factor.

The report also showed disparities when it comes to communities of color. For example, Black women were 40% more likely to die of breast cancer despite having lower rates than white women.

Siegel said this is because minorities have traditionally had less access to high quality health care and that more effort needs to be placed in providing access to disadvantaged communities.

However, the report also had some bright spots. The risk of death from cancer overall has been declining continuously since 1991 with about 3.5 million cancer deaths avoided as of 2019.

"The population-level data seen in this report reflects our experience treating patients. Cancer has become a curable or chronic disease for more Americans," Dr. Deb Schrag, Chair of Medicine at Memorial Sloan Kettering Cancer Center in New York, who was not involved in the report, told ABC News in a statement.

Additionally, although lung cancer continues to be the leading cause of death in the U.S. -- with an estimated 350 deaths per day from lung cancer -- the three-year survival rate has increased from 21% in 2004 to 31%.

Siegel said declines in smoking played a role, but the bigger factors are recent improvements in treatment and lung cancer being detected in early stages.

"One finding was that twice as many lung cancers are being detected at an early stage, and that means more patients are having their cancer detected when they're the most treatable," Dr. Lauren Byers, a lung cancer expert at MD Anderson Cancer Center in Texas, who was not involved with the report, told ABC News.

Siegel said she hopes the new report encourages people to stay up-to-date on their cancer screenings.

"We have a lot of effective screening tests now to prevent deaths from cancer and so, while none of these tests is perfect, being up to date and talking with your doctor about when you should screen can really help reduce your risk of dying from cancer," she said.

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COVID may be with us for a long time. What kind of testing do we need?

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(NEW YORK) -- Throughout the pandemic, periodic surges in demand for COVID-19 testing -- typically during a spike in cases or prior to holiday travel -- have put strain on the nation's testing capacity.

During these times, it can be difficult for people to quickly learn if they are positive for the virus -- and to isolate if they are.

Testing is something the U.S. has struggled to get right from the get-go, from strict rules and problems with the initial test kits to how to manage supply and demand during peaks and lulls. In 2021, America grappled with how to manage the volume of tests needed in a fully reopened country with schools and workplaces requiring regular testing, pressures exacerbated during the highly contagious omicron variant hitting ahead of the holidays.

This presents a real problem because experts believe a successful COVID-19 testing regime -- along with vaccinations -- is the key to building a new normal.

Over the course of the pandemic, the number and types of tests have proliferated, turnaround times for results have varied and other questions arose, including which test should be used and when and where should they be administrated.

So how can the U.S. increase access to tests, and what kind of infrastructure is needed if COVID is going to be an endemic disease, meaning it is always circulating within the population but at low rates. What kind of testing system is needed to prevent further outbreaks fueled by variants including delta and omicron?

Testing experts told ABC News the answer is decentralizing the system and delivering tests to patients directly, setting up community sites with reliable rapid molecular testing and being able to test people for multiple diseases at one time -- including COVID.

The tests we have now

Currently, the U.S. has two different types of viral tests used to diagnose COVID-19: antigen tests and molecular tests.

Antigen tests, also known as rapid tests, look for antigens, or proteins, from the coronavirus and return results usually within less than an hour. Molecular tests, also known as PCR tests, are run in a laboratory for viral material and typically return results within three days.

PCR tests are mostly administered at government-run sites, urgent care centers, doctor's offices and pharmacies, many of which have seen long lines amid the surge fueled by the omicron variant. At-home antigen tests have soared in popularity in recent weeks as way to avoid lines and quickly determine whether or not a person is infected.

How quickly the omicron variant continues to spread will determine whether the U.S. has enough testing capacity for now, the experts say.

"Certainly we have a lot of testing and I think, currently, in the country we can provide well north of two or three million [lab] tests in a day when you consider everything that's available," Dr. William Morice, chair of the Department of Laboratory Medicine at Mayo Clinic, told ABC News.

Currently, the U.S. is performing an average of 1.7 million COVID-19 tests per day, according to data from the Centers for Disease Control and Prevention (CDC). However, experts say we should be performing more tests than that.

Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, told ABC News that the U.S. needs to be performing many more tests -- upwards of 2 or 3 million per day -- so infected people can get the treatment they need more quickly, avoid being sent to the hospital and contact tracing can occur.

"Use of testing, it's not as much to show how many cases we have, but it's actually used for diagnosis " Chin-Hong said. "When people use testing early on, they can get better bang for their buck with early therapies and prevent them from going to the hospital."

He continued, "A PCR test can trigger contact tracing, early therapy. There are a lot of other domino effects of testing that's simply just more than 'I have another case in my community.' It actually ends up potentially saving hospital resources."

Morice believes that if cases continue to rise, then the supply could be strained. The U.S. is recording an average of more than 668,000 infections per day (as of Jan. 7) -- the most ever since the pandemic began, although this figure is partially due to a backlog of data reporting over the holidays.

"When the virus is not prevalent and less common in communities, the testing that we've had, for example here in Seattle, has been quite adequate," Dr. Geoffrey Baird, chair of the Department of Laboratory Medicine and Pathology at UW Medicine, told ABC News. "I think we have plenty of testing available if we were just testing people who have symptoms."

He continued, "But when you have to test asymptomatic people before traveling, before gatherings, before school or before sports, that ends up getting difficult to so support because the absolute number of tests needed can get very, very large."

The experts say that infectious disease modelers didn't predict the emergence of the omicron variant or how quickly it would spread -- especially as people traveled over the holidays -- leading to increased demand for testing.

Dr. Brian Rubin, professor and chairman of the Pathology and Laboratory Medicine Institute at the Cleveland Clinic, told ABC News that at his lab, there have been about 50% more positive tests in 2021 than the year before.

During the previous winter surge, the clinic never had more than 1,000 positive tests per day. In late 2021, as many as 1,700 tests per day come back positive, he said. With as many as 4,000 to 5,000 tests being run every day, this puts a great amount of strain on hospitals, laboratory personnel and testing supplies.

The system we need

Rubin believes the key to building up a robust testing program is to decentralize the system the U.S. has even further, meaning more at-home testing without the need of a healthcare provider to order or perform the test.

"Anything we can do to automate that," he said. "Decentralizing is going to be the key. How do we not call their doctor to order the test, get them to swab themselves, et cetera."

He added, "If we can get really reliable testing into the hands of individuals so you can test at home without leaving your home, we can handle it."

Although most at-home tests currently on shelves are pretty reliable, some at-home tests are known to produce an abundance of false positives.

He envisions a system in which the U.S. uses Amazon or an Amazon-like service to deliver test kits to people's homes on a grander scale than what is already available.

People perform the test themselves, including swabbing and analyzing the sample. Once they get results, they scan a barcode or QR code, alerting public health officials of a positive test result rather than the person having to call a doctor or the local health department to inform them. Although some tests already do this, Rubin would like to see all tests have this capability.

At-home tests have a very low likelihood of delivering false positives if a person is symptomatic. So, under Rubin's proposed system, if the person is symptomatic and gets a positive result, they could stay home and therefore help eliminate long lines at testing sites and free up appointments at clinics.

However, a person who is asymptomatic and gets a positive result from a delivered at-home test would be recommended to get PCR test to confirm they are truly infected with COVID.

Additionally, under Rubin's system, if someone is a contact of a positive patient, they would be informed and get guidance on whether to get tested or quarantine.

"We have all the pieces for home testing, but how do we make it super elegant and slick and make it as easy as possible," he said.

The Biden administration is trying to ramp up testing via a similar method: creating a website that will distribute 500 million free at-home rapid COVID tests to Americans, which officials promised will not cut into the current supply of tests on shelves.

Possible setbacks

However there are issues with rapid tests. At-home testing involves multiple steps and requires a clean workspace, meaning people may be performing the tests incorrectly. Additionally, rapid tests are more likely to return false negatives than laboratory tests because they are less sensitive.

This means that rapid tests have to detect enough antigens, or proteins, in the nose to return a positive result. However, laboratory tests, which look for genetic material, can return a positive result even if only trace amounts are detected.

Because of these potential issues, Baird says he is in favor of setting up community testing sites like UW Medicine has done in Washington that use rapid molecular tests.

These are like PCR tests, which are considered the gold standard of testing, but return results within a few hours rather than within a few days.

The UW community sites collect samples, which are then shipped by courier back to the main lab, where they can be quickly analyzed, Baird would like to see a similar system set up by big hospitals across the country.

"The chances of it giving a false negative are very, very low. No test is 100% perfect but it's as good as you can get and so we're doing the best we can by making the best possible test as expendable as possible," Baird said. "I'd be in favor of multiple community test sites like kiosks or trailers or other sites, it can be in retail spaces or something like that."

Morice said it's also important to have combination tests that check for multiple diseases such as COVID-19 and the flu, which are currently available -- although not at all clinics.

"That will be really important and it's certainly needed," he said. "Last year was really anomalous in that we had no influenza whatsoever. Now we're seeing rates going back up so we'll need it for that reason."

Copyright © 2022, ABC Audio. All rights reserved.

'We're all hurting': Hospital workers plead for vaccination and help amid omicron surge

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(NEW YORK) -- When the omicron variant first began sweeping the country, there was some hope that because initial studies indicated it was less severe, it would prove to have less of an impact on the health care system.

However, given its increased transmissibility, the unprecedented explosion of cases is proving otherwise, leaving a record 146,000 coronavirus positive patients hospitalized across the country.

The record-smashing omicron surge, right on the heels of the crushing delta surge of the summer and fall, is pushing many overtaxed hospital systems over the edge -- systems facing staffing shortages, patients seeking care for non-COVID-related ailments adding to the burden. The increased pressure also comes despite having 62.6% of the country fully vaccinated and an array of treatments at their disposal.

"Even though they say omicron is probably more mild, I don't think we're necessarily seeing that with the unvaccinated," Dr. Raymond Lee Kiser, a hospitalist and nephrologist at Columbus Regional Health in Indiana, told ABC News. "Here in Indiana, this sort of second wave just superimposed right on top of delta."

Across the state, a record 3,400 COVID-19-positive patients are currently hospitalized. In mid-November, there were already more than 1,100 patients receiving care.

"There was barely time to breathe before omicron rolled right on over top of us. It really is just like a second surge right on top of the last one."

On average, more than 18,000 virus-positive Americans are being admitted to the hospital each day, a figure which has more than doubled since early December. In addition, approximately 80% of staffed adult intensive care unit beds are occupied, with more than 23,000 Americans with COVID-19 currently requiring ICU-level care.

Health care workers interviewed by ABC News and officials say the vast majority of those who are severely ill are unvaccinated, leading hospital staff to plead for people to get their shots.

'Very overwhelming'

Echoing many of her colleagues in numerous health care settings, nurse Becky Bevi, at Columbus Regional Health in Indiana told ABC News she is exhausted.

"Two years later, I'm frustrated," said Bevi, who has staffed her hospital's main COVID-19 unit since the beginning of the pandemic. "I feel like this should have been zapped in the first year. Just frustration, tired, exhausted from constantly dealing with it, watching death. It's just so much and I don't feel like it's going to go away anytime soon."

In Wisconsin, nurse Hilary Krieger, said she often feels overwhelmed, given the constant uncertainty that surrounds the virus.

"It's hard to explain. It's lonely. It feels very overwhelming at times," Krieger said.

In the emergency department at Baystate Health, in western Massachusetts, nurse Thomas Mapplebeck, told ABC News that the staff is burned out.

"We're working 12- to 14-hour shifts on Sundays up to 16-hour shifts. Breaks are minimal and it's just that busy, and people are just that sick. Some of us are pushing more than 60 hours a week," Mapplebeck said.

Nationwide, nearly 30% of hospitals, for which data is available, are reporting that they are experiencing a critical staffing shortage.

Mapplebeck shared his harrowing experiences caring for coronavirus patients over the course of the last two years in the hospital's 20-bed emergency room.

"We have patients of all age brackets with no medical history, unable to breathe, their bodies unable to compensate and overcome their symptoms. For some, we take over their breathing for them, we transport them to the trauma center where despite all efforts, they die," Mapplebeck said. "We have 40-year-olds that are trying to walk to the bathroom and get short of breath and collapse and they need resuscitation."

Sicker, faster

Kaila Sizemore, a nurse at Columbus Regional Health, explained that patients appear to be getting sicker, more quickly, compared to previous surges. While the disease was somewhat "more progressive" during the first wave, Sizemore said, now patients suddenly need oxygen and to be transferred to the ICU.

"It's just how quickly and unexpectedly I think that people change has kind of been hardest for me," she added.

At Maine's Northern Light Health, this state's latest surge is the "worst" the staff has ever seen.

"The numbers are crazy," said Melissa Vail, assistant vice president of Ambulatory Care Management. "Our staff is scared. I don't know that we have ever seen anything like this and I don't know that we will ever see anything like it."

Northern Light nurse Allison Leary has also been caring for a growing number of COVID-19-positive children.

"It's challenging taking care of little people ... little kids, and it's sometimes very emotionally draining and intense," said Leary.

Nationwide, pediatric hospital admissions have surged to a record high, with an average of 830 children admitted to the hospital with COVID-19 each day.

"I'm saddened by the fact that we're seeing more kids with it now," Leary said.

Vast majority of those critically ill are unvaccinated

According to health officials, the vast majority of those who are critically ill in the hospitals continue to be the unvaccinated.

"The sickest of the sick that we are seeing now with the patients that are not vaccinated. COVID patients that come in and go home are the ones typically that are vaccinated. They get fluids, medications if needed, and then go home to recuperate," said Mapplebeck, the nurse from Baystate. "This vaccine doesn't put an invisible shield around you like a superhero. It's meant to jumpstart your immune system. So when and if you do become sick with COVID, your body is ready to fight, which gives you a fighting chance."

Kiser added that he has witnessed a dichotomy between those who are vaccinated and unvaccinated. The course for the vaccinated patients, is much milder, he said, typically only requiring a few days of medications, and often, they are able to go home without any oxygen therapy. In addition, the patients who end up getting transferred from the medical floor to the critical care unit are "almost exclusively" unvaccinated.

"If it weren't for that group of people ... I don't think we would feel sort of as physically and emotionally crushed as we do right now," Kiser said.

Mapplebeck, Kiser, of Columbus Regional Health, and others stressed that people should get vaccinated in order to help decrease the number of people who need hospital beds, and give those who are really sick a chance to get the care they truly need.

"Nobody wants to go get a shot, but you know, do this. If you're not going to do it for yourself. Do it for your community. All the hospitals are just struggling right now. All the health care providers are struggling. We're all hurting," pleaded Kiser.

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Ginger Zee on how she overcame the stigma of mental health to talk about suicide, therapy

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(NEW YORK) -- When ABC News chief meteorologist Ginger Zee thinks back to one of the "darkest points' of her struggle with mental health, she thinks of a photo of herself smiling.

In the photo, Zee, now ABC News chief meteorologist, is smiling wide as she sits at the desk at her first on-air meteorologist job at a local TV station in Michigan.

The photo, she said, was taken not long after she attempted suicide for the second time.

"That picture says to me, 'Here's a person who is trying so hard to hide what she was truly feeling,'" Zee said. "It was one of my darkest points in all of my mental health journey, and my smile is so forced and is so big."

Zee said she hopes the takeaway from the photo for people is that a person who appears smiling, who is functioning in society, can at the same time be struggling with their mental health.

"I hope that me talking about it can help distinguish for people that just because you look bright and sunny does not mean that that is what's happening on the inside," she said. "All of us are complex human beings. We are also allowed to have a really big smile one day and a non-smile the next day."

Zee, a mother of two, she said her mental health struggles began "at a very young age," but went unaddressed, in part because mental health was even more taboo at that time.

"It was the 1980s, and a lot of people didn't know what to do," Zee said. "I don't think my parents could have been educated enough to recognize it or see it."

Zee said she turned to anorexia as a young girl as a way to feel more in control of her life. When she was in college and went on medication to treat narcolepsy, Zee said the "extremes" of her depression began to appear.

She had her first suicide attempt while in college, followed by the second, several years later, while working as an on-air meteorologist.

As Zee has worked through her own recovery, she said she has tried to break the stigma of mental health by speaking about it publicly, first in her bestselling book Natural Disaster and now in her newly-released follow-up, A Little Closer to Home.

She described people as often being "shocked" when they hear her talk about therapy and hospitalization, especially after seeing her smiling on TV each morning on GMA.

"A lot of times they'll say, 'I would have never known you were that sick, or you were that deep into something,'" she said. "That's fine because you can't see it. That's what makes it hard every time, and that's what makes it tough for people to be able to react or not know how to react."

In the United States, nearly one in five adults, over 51 million, live with a mental illness, according to the National Institute of Mental Health (NIMH).

Starting at puberty, young women are at the greatest risk for major depression and mental disorders due to physiological changes. As women age, they also experience certain depression-related illnesses than men don't, such as postpartum depression and postmenopausal depression and anxiety.

Zee said that as a woman in the public spotlight, she panicked when she decided to go public in her first book about seeking treatment for her mental health in a hospital.

"When my first book was about to be printed, and the first line was, 'I checked myself into a mental health hospital,' I woke up in the middle of the night, and it was like, 'Oh my gosh, I'm gonna ruin my life, my career, nobody's gonna hire me,'" Zee recalled. "And I'm telling my husband all this."

Zee said her husband, Ben Aaron, helped her overcome her fear by reminding her that people want to hear not just the superficial, good stuff, but also the real-life stories of struggle and growth.

"He kind of told me to get over that hump, and once I did, it was unbelievable how much healing I felt," Zee recalled. "It was the first time that I said, 'Here's who I am, and if you don't like it, I guess I don't care,' and that was so powerful."

Even as Zee has gotten to a point where she feels confident sharing her story, she said she recognizes that is not the case for everyone, adding that she forges ahead because she wants the "stigma" of mental health treatment to end.

"I think we've gotten a lot better about being able to identify and be OK with sharing, 'I have depression,' or 'I have anxiety.' People say that a lot," said Zee. "What people don't say is, 'I go to therapy,' or, 'I had to go to the hospital.'"

"When I say, 'I checked myself into a mental health hospital,' eyebrows still raise, and that's OK. I'm OK with people raising their eyebrows around me saying that, because I want that stigma to end."

For Zee, talking about her hospitalization is especially important, because it was that in-patient treatment, which she sought weeks before she began working at ABC News in 2011, that started her recovery.

"It's where I got my diagnosis, that was the first diagnosis that was right. It's where I finally came to terms with, OK, I really do need that much help," Zee said. "And it's where I finally found a sliver of hope that wanted me to live and have a life and go forward."

How Ginger cares for her mental health today

Just over one decade later, in 2022, Zee said being public about her own mental health struggles has been a constant reminder to her that healing is an ongoing journey, not a destination.

"What writing these books and talking about mental health has done for me is it has said to me, 'You don't just heal, and then you're done. Healing is a constant maintenance,'" Zee said. "Just like physical health, you don't go and get in sick shape and have a personal trainer for a year and eat right for 12 months and then you stop and everything stays the same. That's not how it works, and that's not how it works with mental health either."

As people make New Year's resolutions and set goals for 2022, Zee said her hope is that they, "be kind to themselves and work on their mental health first."

Zee said it helps her to look at coping with mental health as a "lifelong workout" for her brain, explaining, "That's where I put my energy, my money, my time is in the mental health first, and then all the other stuff falls into place."

"People say, 'Oh, I carve out an hour, five days a week to workout,'" she added. "I carve out an hour so that I can put focus on how am I going to make my mental health the most stable it can possibly be."

In addition to therapy, Zee said she constantly finds ways to incorporate service, meditation and gratitude into her daily life.

Zee shares five of her centering practices below:

1. Set an intention for the day: "I still do gratitude every morning on my windows on my shower," said Zee. "In the steam, I write what I'm grateful for, I set an intention for the day."

2. Practice meditation: "I try to do yoga and pilates, but with mind meditation within it," Zee said, adding that she adds in meditation in other practical ways, like when she's getting a manicure, noting meditation doesn't have to be thought as something formal that is only done in traditional ways.

"Meditation is the setup of the brain," she said of its importance. "The personal trainer to me is my therapist, and then there's the meditation, which is like [doing] the sit-ups."

3. Write down your thoughts: "Start by being honest with yourself, write it down," Zee said. "As soon as you do that, as soon as you write down your feelings of what you're feeling honestly, it takes power away from whatever it is you're fighting."

4. Recognize that what you're feeling is a moment in time: "If I could go back in my darkest places and if I could impart one piece of wisdom ... I would have said, 'This is going to feel so different tomorrow,'" Zee said. "It really is. It's going to feel different the next day, and it might get worse again, and might get better again, but every single moment is fleeting."

5. Reach out for help: Zee said she has a support system, including her mom and husband, whom she reaches out to immediately when she is having what she calls a "grey day."

"They know what that means. They know how to support me," Zee said. "And then from here, I allow myself to have a grey day, and I do everything to support being healthy through that grey day."

For people who feel like they don't have support, Zee said there are many safe places and safe people to whom they can say, "I need help," aloud.

"Realize, what's the worst thing that's gonna happen when you say it aloud," said Zee. "The worst thing that's gonna happen if someone judges you, I think that's a lot better than losing your life, or living in the sad, dark place that many people are living in, because they're not saying it out loud."

"If you say to someone that you love, or that is a friend, or that is a co-worker even, 'I think I need some help,' we're going to help you,” she said.

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

Copyright © 2022, ABC Audio. All rights reserved.

Breastfeeding linked to lower risk of heart disease in women, study finds

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(NEW YORK) -- Breastfeeding has now been linked to another added benefit for moms.

Women who breastfed at some point in their life were less likely to develop heart disease or a stroke or die from cardiovascular disease than women who did not breastfeed, according to a study published Tuesday in the Journal of the American Heart Association (JAHA), a peer-reviewed journal of the American Heart Association.

The study, which analyzed data from over 1 million women around the world, found that women who breastfed had an 11% reduction in cardiovascular events, a 14% reduction in coronary heart disease, a 12% reduction in strokes and a 17% reduction in fatal cardiovascular events compared to women who never breastfed.

“It’s important for women to be aware of the benefits of breastfeeding for their babies’ health and also their own personal health,” Dr. Peter Willeit, the study's senior author and professor of clinical epidemiology at the Medical University of Innsbruck in Innsbruck, Austria, said in a statement. “Moreover, these findings from high-quality studies conducted around the world highlight the need to encourage and support breastfeeding, such as breastfeeding-friendly work environments, and breastfeeding education and programs for families before and after giving birth.”

The newly-released study found increasing benefit for women who breastfed up to 12 months cumulatively, with the benefits plateauing for any time beyond that.

The American Academy of Pediatrics (AAP) recommends that infants be exclusively breastfed for the first six months of life.

In addition to providing important health benefits for babies, breastfeeding has also been shown to decrease the risks of breast, ovarian, endometrial and thyroid cancers in women, and lower the risk of type 2 diabetes, hypertension and rheumatoid arthritis, according to the AAP.

The new findings on the benefits of breastfeeding stand out because heart disease is the leading cause of death for women in the United States, according to the Centers for Disease Control and Prevention (CDC).

Heart disease causes about one in every five female deaths in the U.S., according to the CDC.

For women age 20 and older, about 1 in 16 have coronary heart disease.

While breastfeeding has proven health benefits for both babies and moms, whether or not a mom breastfeeds her child should be a "judgment-free zone," according to Dr. Jennifer Ashton, ABC News' chief medical correspondent and a board-certified OBGYN.

"[Breastfeeding] is not possible or desirable for every new mom, and this should be a judgment-free zone," said Ashton. "Obstetricians, midwives, pediatricians – our job is to educate and inform. It is that mother’s job to decide what she feels is best for her baby."

Siobhan Deshauer, M.D., FRCP, a resident in the ABC News Medical Unit, contributed to this report.

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Family speaks out after man receives pig heart in 1st of kind transplant


(NEW YORK) -- A 57-year-old man who underwent a first-of-its-kind heart transplant involving a genetically-modified pig heart is in a "much happier place" after the transplant, according to his son.

David Bennett Sr., of Maryland, suffered from terminal heart disease and was deemed ineligible for a conventional heart transplant because of his severe condition, according to University of Maryland Medicine, where Bennett underwent the transplant.

On New Year's Eve, University of Maryland Medicine doctors were granted emergency authorization by the Food and Drug Administration to try the pig heart transplantation with Bennett, who had been hospitalized and bedridden for several months.

Bennett said he saw the risky surgery as his last option.

"It was either die or do this transplant. I want to live. I know it's a shot in the dark, but it's my last choice," he said the day before the surgery, according to University of Maryland Medicine. "I look forward to getting out of bed after I recover."

Bennett was so sick before the transplant that he was on an extracorporeal membrane oxygenation (ECMO) machine -- which pumps and oxygenates a patient's blood outside the body -- and had also been deemed ineligible for an artificial heart pump, according to University of Maryland Medicine.

"His level of illness probably exceeded our standards for what would be safe for human heart transplantation," said Dr. Bartley P. Griffith, a professor in transplant surgery at the University of Maryland School of Medicine.

It was Griffith who surgically transplanted the pig heart into Bennett. He and a team of researchers have spent the past five years studying and perfecting the transplantation of pig hearts, according to University of Maryland Medicine.

Pig hearts are similar in size to human hearts and have an anatomy that is similar, but not identical.

So far, Bennett's body has not rejected the pig heart, which experts said is the biggest concern after a transplant.

Xenotransplantation, transplanting animal cells, tissues or organs into a human, carries the risk of triggering a dangerous immune response, which can cause a "potentially deadly outcome to the patient," according to University of Maryland Medicine.

"It is a game-changer," Dr. Muhammad Mohiuddin, professor of surgery at the University of Maryland School of Medicine, who oversaw the transplant procedure with Griffith, said. "We have modified 10 genes in this in this pig heart. Four genes were knocked out, three of them responsible for producing antibodies that causes rejection."

Mohiuddin and Griffith said they are now closely monitoring Bennett to make sure his body continues to accept the new heart.

"He's awake. He is recovering and speaking to his caregivers," said Griffith. "And we hope that the recovery that he is having now will continue."

Speaking of the possibility of rejection, Griffith added, "The pig heart will be attacked by different soldiers in our body, different immune players can take it out and we have designed a treatment plan, in addition to the humanized, genetically-edited heart, to try to account for that."

Bennett's son, David Bennett, Jr., told "Good Morning America" the transplant provided his father a "level of hope."

"Hope that he could go home and hope that he could have the quality of life that he's so much desired," Bennett, Jr said. "He's in a much better place and a much happier place right now following this transplant procedure. He is happy with where he is at. Happy with the potential to get out of the hospital."

While the type of transplant Bennett received is groundbreaking, experts said it does not minimize the ongoing need for human organ donations.

Around 110,000 people in the United States are on the organ transplant waiting list, and more than 6,000 patients die each year before getting a transplant, according to the Department of Health and Human Services.

"Whether it's 3-D printing or growing organs in a lab setting or donations, we desperately need more organs," said ABC News chief medical correspondent Dr. Jennifer Ashton, a board-certified OBGYN.

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Nursing homes struggle with low booster rates, staffing issues as omicron spreads

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(NEW YORK) -- As the omicron variant causes a surge in coronavirus cases, many long-term care facilities are facing challenges not seen in months, officials from around the country tell ABC News.

Many nursing homes are struggling with low booster rates and a growing staffing crisis, said industry executives and health care advocates.

"Nursing homes are on high alert right now," said Terry Fulmer, president of the John A. Hartford Foundation, a nonprofit that works to improve care for older adults. "Omicron is highly transmissible and is spreading through communities like wildfire."

In the week ending Jan. 2, nursing homes and long-term care facilities reported close to 15,000 cases across the country, three times the infection rate from just a month ago when facilities were reporting under 5,000 cases, data released by the Centers for Disease Control and Prevention shows.

Cases among staff members have shot up at an even higher rate, with facilities reporting upwards of 34,000 cases in the week ending on Jan. 2, compared to just over 5,600 a month ago.

In Sussex County, New Jersey, the National Guard was deployed last week to assist nursing home staff with infection control protocols and other duties as multiple facilities saw COVID-19 outbreaks.

"The staff at these facilities have been particularly hard hit by the latest COVID variant," County Commissioner Anthony Fasano said in a statement. "We believed it was prudent to get them the help they needed before there was a crisis."

In California, after more than 5,000 new cases were reported in skilled nursing facilities, the state's public health officer, Tomas Aragon, announced that boosters will be mandatory for health care works and that visitors will require additional testing.

According to the CDC data, the recent spread of the virus among long-term care residents is occurring primarily among unvaccinated and twice-vaccinated residents, while the infection rate remains low for residents that have received a booster shot.

For most adults, two doses of currently authorized COVID-19 vaccines dramatically reduce the risk of being hospitalized or dying of the virus. But elderly adults, whose immune defenses fade with age, may still be at higher risk of serious illness from COVID-19, especially if it's been more than five months since their last shot.

As of Jan. 2, more than 87% of residents at nursing homes nationwide had received two shots, and nearly 62% had been boosted, according to the CDC data.

For industry advocates, increasing the number of residents and staff getting boosters is a priority.

"We have been urging long-term care providers to get ready and to get ahead of the surge by ramping up their booster efforts," said Cristina Crawford, a spokesperson for the American Health Care Association/National Center for Assisted Living.

Hartford told ABC News that she's especially concerned that the rate of booster shots among staff is lagging behind.

"We have to increase our efforts to get boosters into the arms of both residents and staff," she said.

In Ohio, where around 40% of nursing home staffers remain unvaccinated and the 21-day case average is above 14,000, omicron has "exacerbated" the growing staffing crisis, said Pete Van Runkle, executive director of the Ohio Health Care Association.

"Cases in long-term care in Ohio are about four times as many with omicron as during the height of delta," Runkle told ABC News.

"The biggest problem with the incredibly high transmissibility is staff missing time from work," he said.

The good news, said Runkle, is that despite the rising number of cases, nursing homes are reporting "very few" COVID-related deaths compared to last winter's surge.

Across the country, death rates among long-term care residents and staff have remained flat throughout the spread of omicron. Nationally, facilities have reported 405 deaths among residents in the week ending Jan. 2, compared to 485 deaths in the week ending Dec. 5, according to data released by the CDC.

Pennsylvania state Health Care Association CEO Zach Shamberg said the good numbers are the result of a multi-pronged approach.

"This is a complete 180 from what we have seen last year and is a credit to providers and front-line workers who are doing everything they can to mitigate the spread of the virus now that they better understand the virus, have PPE and tests, and most importantly, access to a vaccine and boosters that help provide an additional level of protection for residents and workers," Shamberg said.

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San Francisco reducing COVID testing hours because of staff shortages


(SAN FRANCISCO) -- The San Francisco Department of Public Health said it is reducing hours at some COVID-19 testing sites due to staffing shortages.

The decision comes despite warnings from experts about the importance of COVID testing to keep up with the surge of the highly transmissible omicron variant.

"On Monday, some SFDPH-affiliated sites will temporarily reduce testing hours due to challenges beyond our control," the department tweeted Sunday. "Please check your health system first for testing. Do not go to the ER for tests."

In a statement released Monday, SFPDH said it expects testing capacity will only be reduced "by about 4%, or approximately 250 tests per day out of the current 7-day average of 6,000 tests per day at SFDPH-affiliated sites."

Additionally, only four sites are being impacted by reduced hours and the department insists the change is temporary.

It's unclear how many workers are out sick. San Francisco Mayor London Breed revealed last week that more than 400 city employees were out due to either COVID-19 infections or isolation after potential exposure.

It comes as San Francisco is recording an average of 1,245 new cases per day, which is the highest ever since the pandemic began and a 1,600% increase from one month ago, city data shows.

Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, told ABC News he is worried the reduced hours will mean that COVID-19 cases are missed.

"It's going to have a terrible impact," he said. "It reminds me of early March 2020 when we didn't have enough testing. Of course we have a lot more tests numerically, but the proportion seems to be the same because the percentage of those needing testing is definitely not met by the number of available tests."

Matt Haney, a member of the San Francisco Board of Supervisors, said reducing the hours of operation at COVID-19 testing sites is unacceptable.

"It was already hard to get a test in San Francisco and now it just got harder and that’s unacceptable," he told ABC News. "Our department of public health had expanded capacity at a number of sites. But it wasn't enough. Now they’re cutting back because of staffing shortages."

Testing capacity has been stretched to an all-time high, according to SFDPH.

Haney, however, argued that testing sites need to make sure they are consistently meeting demand.

"The level of demand for tests exceeds anything we had seen," he said. "Health officials also feel the private providers need to do more testing. I think all of those things are true, yet our residents need our public health department to step up and get the job done."

Haney wants to call a hearing on testing to get more answers on why it's been so difficult for residents to get tests.

"You may have heard that people are calling 911 to get tested," he said. "When people get exposed or they're not feeling well, if the county tells them go to get a test and then they can’t get tested, that’s freaking them out and they're calling 911 -- and our 911 lines are overwhelmed because what people are being told to do can’t be done."

There are ways to prevent the staffing shortages from having a large impact, according to Chin-Hong, such as deploying the National Guard to sites, which Gov. Gavin Newsom did over the weekend.

"There are also some creative strategies like utilizing student volunteers who are in health professions, like medicine, nursing, pharmacy, to go out," he said. "They have some medical background. It's kind of an all hands on deck perspective. It doesn't take a lot of training to do a swab; people do that at-home after all."

He also recommended that testing sites become more diverse and be expanded to offices, community centers and banks.


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US hospitals strained with influx of patients amid latest COVID-19 surge, staffing shortages

Jeffrey Basinger/Newsday via Getty Images

(NEW YORK) -- Explosive COVID-19 surge strains hospitals and schools around the nation
The number of hospitalized Americans who are positive for COVID-19 soared to more than 138,000.

For nearly two years, day after day, under exhausting and often dangerous conditions, health care workers across the country have continued to care for the nation's sickest Americans who have fallen victim to coronavirus.

As the highly infectious omicron sweeps through the country, the United States is now facing its most significant coronavirus infection surge to date, putting additional pressure on an overtaxed health care system.

"We have seen an incredible proliferation of the virus in hospitals, such that we went from a place where virtually no county in the country was at risk of exceeding its capacity to well over half are now. I don't like to make predictions, but things could get very bad in the coming couple of weeks," Dr. Jeremy Faust, an emergency physician at Brigham and Women's Hospital in Boston, told ABC News.

Although preliminary global studies indicate that the omicron variant may cause less severe illness than prior variants, health officials say that the sheer numbers of infections caused by the new variant could still overwhelm the health care system.

The burden on the health care system is made worse by nationwide staffing shortages and hospital capacity at elevated levels as many other patients seek care for non-virus related reasons.

"Due to the tsunami of omicron cases, the volume is affecting our health and community service," said Dr. Rebecca Weintraub, assistant professor of Global Health and Social Medicine at Harvard Medical School. "While we are very lucky hospitalizations have decoupled, the vast spread is alarming."

Late last month, Dr. Anthony Fauci, chief medical adviser to the White House, pointed to the disparity between cases and hospitalization as a "strong" indicator that omicron is less severe, as the U.S. has not experienced a concomitant increase in the relative percentage of hospitalizations.

Even so, Fauci warned that there will still be many virus-positive Americans who will seek medical care, creating further strain on hospitals.

"Even if you have a less of a percentage of severity, when you have multi-multi-multi-fold more people getting infected, the net amount is you're still going to get a lot of people that are going to be needing hospitalization. And that's the reason why we're concerned about stressing and straining the hospital system," Fauci told ABC News' George Stephanopoulos during an appearance on This Week, earlier this month.

Experts say the baseline for hospitalizations is already higher than it was a year ago, with hospitals described by some experts as "relatively quiet" last winter for ailments other than COVID-19, which provided a "much bigger buffer zone," to care for the most critically ill. In addition, hospitals were already struggling with patients from the delta wave.

"We entered this wave, with hospitals at a higher capacity than they were in previous waves, from non-COVID [health issues]," Faust explained. "That's the real problem."

Highly localized surges a pain point for many communities

An ABC News analysis of federal data found that in recent weeks, total hospitalizations -- COVID-19 and non-COVID-19 related -- have seen an uptick. The number of COVID-19-positive Americans who are hospitalized is now nearing a pandemic high, with more than 138,000 Americans hospitalized, and an average of 17,000 being admitted to hospitals each day.

Most of the patients who are requiring intensive care are still unvaccinated, according to top health officials, including U.S. Centers for Disease Control and Prevention Director Rochelle Walensky.

Experts say there is no overarching experience for how COVID-19 is now affecting the country, as surges are asymmetric, and the impact of COVID-19 will look different for every community.

"Ground conditions matter beyond belief," Faust said, explaining that while one area can see an uptick in COVID-19 infections, hospitals may not become overwhelmed, because they have adequate staffing or a highly vaccinated and younger population, hospitals in other areas with lower vaccination rates and fewer resources could find themselves completely overwhelmed.

"There are places where incidental infection is a higher proportion of admissions than others. The reverse is true in other areas. And there are places with higher vaccination rates than others. When an unvaccinated person gets admitted to the hospital, they are going to be sicker and require more care and take up more resources. Every place is different," Faust added.

Even within a state, the timing of surges is also highly localized, experts say, varying by areas and even by hospital. Thus, even if hospital capacity nationwide or on the state level looks relatively stable, "micro surges," seen in individual facilities or communities may still be occurring and threatening care.

Even virus-positive patients who are not admitted primarily for COVID-19 are adding a strain

Nationwide, it remains unclear as to how many patients are being admitted to the hospital for coronavirus-related care, and how many patients are coincidentally tested positive for the virus, after they were admitted for other reasons and subsequently checked for positivity as a routine check.

In New York, state officials reported on Friday that 42% of COVID patients were admitted for non-COVID reasons, and in Florida, Gov. Ron DeSantis cited data from three of the state's major hospitals, which reported that half, or more, of their COVID-19 positive patients are getting treated for other conditions, not the virus.

However, some experts and hospital officials have cautioned that the proportion of patients seeking care specifically for COVID-19 likely varies widely community by community. In addition, health officials say a COVID-19 diagnosis can cause additional strain on a health system, as virus-positive patients in many hospitals are required to be treated differently.

In a series of tweets last week, Dr. Ashish Jha, dean of the Brown University School of Public Health, stressed that both patients "with COVID-19" and those admitted "for COVID-19," have an impact on care, utilization, and can stress the health care system.

Patients, who may have come in for another ailment, such as a broken leg, and are found to be positive for the virus must stay in a COVID-19 isolation room, explained Jha, who added that there are already a limited number of such rooms available.

In addition, every time a health care worker enters a room with a COVID-19 positive patient, they must be wearing full PPE, which in turn, prolongs wait times for many patients.

"Admissions with COVID is still very disruptive to the health care system, at a time when it can't afford more disruption," Jha said.

Federal data shows the emergency department visits with diagnosed COVID-19 cases are currently at their highest point of the pandemic -- a figure that has more than doubled over the last month.

"People are in the ER for hours and days, creating gridlock for new patients that need emergency services every day," said Dr. Jay Bhatt, an internist and adjunct faculty at the UIC School of Public Health and an ABC News Med Unit contributor.

Other hospital officials have noted that even if patients are admitted for a reason other than COVID-19, a COVID-19 infection on top of another condition may only exacerbate an individual's original illness.

At Cincinnati Children's Hospital Medical Center, hospital officials told ABC News that they have seen their COVID-19 positive patient totals "skyrocket" in recent weeks. Some of these patients happen to test positive while admitted for other concerns, while others are primarily sick with COVID-19.

"Even the children who are not admitted primarily for COVID have hospital courses that are further complicated because of COVID. Having cancer, heart issues, appendicitis, and COVID is never a good thing," one hospital representative said.

A growing shortage of hospital staff 'wreaking havoc' on the health care system

Surge after surge, nurses, doctors and respiratory technicians have led the fight against the virus, many forced to leave their families for weeks to months at a time in order to avoid a total collapse of the health care system during the pandemic.

Since the onset of the pandemic, the already existing staffing shortage has only grown worse, and now experts say they are concerned there will not be enough front-line workers to care for the influx of patients in need as many of them are forced into isolation and quarantine after testing positive.

"I am worried we don't have enough health care workers to care for patients flooding hospitals," said Bhatt. "[The] unprecedented numbers of sick clinical staff [are] wreaking havoc on hospitals and health systems as they do their best to care for patients in this current surge. I have not seen a workforce issue as serious as this, and is deeply concerning."

As of January 2022, there have been at least 819,000 coronavirus cases among health care personnel, and more than 3,100 virus-related deaths.

Late last month, the CDC shortened the isolation time for COVID-19-positive health care workers in anticipation of the potential shortages that might occur amid the latest surge.

Many health care workers say they are exhausted as they train to keep their facilities running.

"There are wait times in the emergency department that are running six to eight hours, in the trauma center. [In the] emergency room sometimes it runs greater than 24 hours. So you know we ... the nursing staff is tired, we have burned out. We're working 12- to 14-hour shifts, on Sundays up to 16-hour shifts," Thomas Mapplebeck, a nurse in the Emergency Department at Baystate Health told ABC News.

Staffing shortages are also preventing some people from receiving the critical care they need, added Bhatt, who said that some patients in need of hospice are struggling to receive placement because of the shortages.

The unknown of what's to come

Many health officials and experts have tried to forecast what Americans can expect from the virus in the months and weeks to come, and when COVID-19 will finally enter an endemic phase. However, Faust explained he is reluctant to make predictions as there is still so much unknown surrounding the virus.

"Five weeks ago, we'd never heard about omicron because it didn't exist as far as we know, and now we were in the worst part of this pandemic," Faust said.

With many younger Americans becoming infected, Faust said it is possible intenstive care unit bed capacity may not be overrun. It is also possible the virus could reach the millions of Americans who are still unvaccinated, as well as many at-risk people who remain vulnerable for severe illness.

An additional roadblock for some hospitals has been delays in returning patients to nursing rooms, further exacerbating the shortage of beds.

"Patients who are ready for discharge are having trouble getting back to long-term care, nursing home facilities, short-term rehab and home without social support as resources are strained and this creates a logjam that strains the system and workforce even further," Bhatt said. "We can't have situations where we are having trouble getting patients back to the community so that others that really need hospital care can get it. We can and need to do better."

The worst-case scenario, said Faust, will be if nursing homes see significant spikes.

"If that happens in places that are already on the edge, we will see horrifying scenes that we've been warning against for a long time," Faust said.

Health officials have stressed it will be critical for Americans to modify their behavior by wearing masks, avoiding mass gatherings and getting vaccinated.

"I hope people can do their part to get vaccinated, decrease the number of people who need hospital beds so that these other folks who are really sick have a chance to get the care that they need," said Dr. Jeff Pothof, an emergency medicine physician at UW Health in Madison Wisconsin. "It's really bad right now," he added.

Benjamin Rader, a research fellow at Boston Children’s Hospital, contributed to this report.

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