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Fauci says he has serious doubts Russia's COVID-19 vaccine is safe, effective

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.

Copyright © 2020, ABC Audio. All rights reserved.

'Shock hair loss' linked to coronavirus pandemic stress

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."

Copyright © 2020, ABC Audio. All rights reserved.

Selma Blair opens up about riding her horse for the first time since MS diagnosis

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.

Copyright © 2020, ABC Audio. All rights reserved.

'Every single body is a bikini body': Body-positive advocates discuss inclusive swimwear shopping tips and best picks

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.

Copyright © 2020, ABC Audio. All rights reserved.

Scientists tested 14 types of masks: Here's what worked and what didn't

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.”


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.

Copyright © 2020, ABC Audio. All rights reserved.

Inducing hypothermia can help get ICU patients with COVID-19 off ventilators


(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.

Copyright © 2020, ABC Audio. All rights reserved.

Fauci to David Muir: US in for ‘difficult time’ if COVID-19, flu outbreaks converge


(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.”

Copyright © 2020, ABC Audio. All rights reserved.

Fauci to David Muir: ‘Universal wearing of masks’ essential to combat COVID-19 spread


(NEW YORK) -- Dr. Anthony Fauci told “World News Tonight” anchor David Muir that the viral photo of a crowded school hallway in Georgia taken last week was “disturbing.”

“There should be universal wearing of masks,” he said Monday when asked about reopening schools. “There should be the extent possible social distancing, avoiding crowds. Outdoors [is] always better than indoors and [you should] be in a situation where you continually have the capability of washing your hands and cleaning up with sanitizers.”

“When I see sights like that, it is disturbing to me,” Fauci added.

Hannah Watters, a 15-year-old sophomore at North Paulding High School in Dallas, Georgia, captured the image in the school’s hallway. She was suspended within 24 hours after sharing the photo on social media but then had the punishment revoked days later.

On Monday, officials announced the school would close for cleaning after nine people tested positive for COVID-19.

Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and an advisor to six U.S. presidents, recommends “a comprehensive way to really avoid the things” the viral photo captured, including the lack of masks and social distancing in an enclosed space.

While he conceded that mask-wearing guidance will be decided at the local level, he said the “universal wearing of masks is one of five or six things that are very important in preventing the upsurge in infection and in turning around the infections that we are seeing surge.

Copyright © 2020, ABC Audio. All rights reserved.

Twenty-six states will soon face shortage of ICU doctors

iStock/sudok1BY: DR. MOLLY STOUT

(WASHINGTON) -- They built field hospitals, transformed operating rooms into ICUs, and ingeniously crafted their own ventilators and masks. And now they're strapped for the people who make up a critical care workforce.

Researchers at George Washington University's Milken Institute School of Public Health found that the majority of states are now at risk for shortages in healthcare workers needed to treat critically ill patients, including those with COVID-19. This week’s report shows alarming projected shortages over last week in doctors, nurses, respiratory therapists and pharmacists.

The most recent update finds that 26 states will soon face shortages in ICU doctors, up from only five last week. Ten states are at risk of running low on critical care nurses. Seven face shortages in doctors trained to work in hospitals. Nine states will not have enough respiratory therapists, up from zero last week. Six states will face shortages in pharmacists. This stark prediction brings back recent memories of workforce shortages in New York City when health care workers from all over the country answered the call to action.

“These highly trained doctors, nurses, respiratory therapists and pharmacists all work together to provide potentially life-saving care to COVID-19 and other seriously ill patients,” said Patricia Pittman, PhD, director of the Fitzhugh Mullan Institute for Health Workforce Equity at the Milken Institute. “At a time when COVID-19 continues to surge in the United States," she added, "our current analysis shows that most states are at risk of running low on these critical healthcare workers.”

Pittman’s team created a tool called the State Hospital Workforce Deficit Estimator to help states and the federal government gauge the demand for healthcare professionals given different scenarios of COVID-19 and the normal attrition rates for workers. The Workforce Estimator allows policymakers to plan for looming spikes in COVID-19 cases and begin staffing up to help meet the demand.

Despite an increased ability to track trends in workforce shortages, the problem is a more challenging one to address given how long it takes medical and pharmacology students to be trained to work in an ICU. ICU doctors have nearly six years of training after medical school to become board certified, and ICU pharmacists complete two years of residency after four years of pharmacy school.

The problem of a shortage of healthcare workers in ICU is not new, but it is certainly a more pressing one in the context of a pandemic. In 2019, the Society for Critical Care Medicine (SCCM) released a statement on the projected workforce shortage and possible solutions. The SSCM's Fundamental Critical Care Support program, aimed toward rural and other areas underserved in critical care, offers a shorter, certificate program to non-ICU physicians, nurses, nurse practitioners and physicians assistants who often lack critical care training.

Telemedicine services may pose another mitigation strategy in specific circumstances to address the need. Advanced practice providers, such as nurse practitioners and physician assistants may be more easily pulled up the ranks to round out a multidisciplinary team.

Intensive care is primary example of a team sport in medicine, and if hospitals are not fielding adequate teams, even with state-of-the-art equipment, they cannot expect to help their patients win the battle against the coronavirus.

Molly Stout, MD is a dermatology resident at Northwestern in Chicago and a contributor with the ABC News Medical Unit.

Copyright © 2020, ABC Audio. All rights reserved.

As coronavirus fatalities decline nationwide, deaths persist in US nursing homes


(NEW YORK) -- Even as death rates from the novel coronavirus have declined overall, nursing homes in the U.S. have persisted as one of the deadliest environments in the pandemic, according to a new ABC News analysis of the latest public health data.

"Nursing home residents remain at risk," said Dr. Jay Bhatt, an internist in Chicago and ABC News contributor, citing seniors' unique vulnerabilities to COVID-19 and a "broken and patchwork system of care delivery."

Since March, long-term care facilities across the nation have been ravaged by the coronavirus and have accounted for roughly 40% of virus-related deaths, data shows. Nursing home residents have taken steps to try and halt the spread by closing doors to loved ones, eliminating group activities and implementing strict protocols to isolate themselves.

Nationally, coronavirus infections have not been leading to deaths as frequently as they did earlier in the outbreak, according to public health data. While July had by far the most cases, the deadliest month of the outbreak was in April. According to the COVID Tracking Project, in April there were nearly 54,000 deaths while in July, there were 25,295 deaths.

ABC News conducted an analysis of state-by-state reporting of positive cases and deaths in America's nursing homes. And more than six months into the effort to fight the outbreak, those numbers show the virus continues to find pathways into nursing homes, accounting for at least 63,000 of the nation's more than 162,000 total coronavirus deaths.

Once the virus enters a nursing home, the percentage of positive cases that will lead to death has declined only slightly, from 21% to 18%. And in some states where the virus has slowed among the broader public, the cases have continued to climb in nursing homes, data from state health departments show.

In New Hampshire, for instance, where nursing homes accounted for 57% of deaths back in late May, they now account for 82% of total deaths. Similarly in Kentucky, where nursing home fatalities accounted for 56% of deaths in late May, they now make up 63% of those who succumbed to the disease. In Indiana and Ohio, where the percentage neared 50% back in May, the numbers have crept up to 54% of total deaths in August.

Connecticut, Delaware, Maine, Massachusetts, Minnesota, North Dakota, Pennsylvania and Rhode Island all continue to show significant death tolls in nursing homes, even as the overall number of fatalities has declined -- with the facilities accounting for more than 60% of each state's total number of deadly cases.

Bhatt said younger patients are surviving better as health care facilities are getting smarter about how they care for people stricken by the virus. But those advances have not extended as easily in nursing homes because, he added, of the vulnerabilities that make older adults especially susceptible targets -- such as weakened immune systems and other health complications.

As the number of fatalities in nursing homes continues to remain high, multiple efforts are underway to protect nursing home residents. In mid-July, the federal government announced it would send rapid testing kits for COVID-19 to all skilled nursing facilities in the country. So far, tests have been delivered to 1,500 locations, federal officials told ABC News.

But the new testing initiative has raised concerns among advocates and nursing homes about the accuracy and cost of the tests.

"To me, the accuracy is just so essential," said Richard Mollot, the executive director of the Long Term Care Community Coalition, an organization that advocates for nursing home residents. "If you don't have an accurate test then we're kind of wasting people's time and resources."

LeadingAge, an association of nonprofit providers of aging services that includes many nursing homes, recently sent a letter to Adm. Brett Giroir, the assistant secretary for health at the Department of Health and Human Services, which pointed out that while antigen testing is useful for rapid results, the tests have a 20% false-negative result. LeadingAge also estimated that weekly costs for facilities with 100 employees would be nearly $20,000. They did not provide underlying figures.

According to the Department of Health and Human Services (HHS), each nursing home in the U.S. will receive one diagnostic test instrument and associated antigen tests. Following initial distribution, nursing homes will be able to purchase additional tests directly from the manufacturer.

"When our nursing home receives the rapid test kits, we're responsible for paying for the tests," said Matthew Solomon, a spokesperson for Aviva, a nursing home in Florida. "Right now normal COVID-19 tests are costing us about $100 per test. And we have 300 residents so how are we going to pay for that?"

Solomon said his nursing home had its first positive coronavirus case about two weeks ago and ran out of federal stimulus aid on July 31.

The $2 trillion coronavirus relief packaged passed by Congress in March created mechanisms by which nursing homes could receive federal aid to help them combat the virus and keep employees on the payroll. In late July, HHS expanded the application window for some Medicaid and Medicare-funded facilities to apply for additional aid, but Solomon said his facility is no longer receiving federal support.

Congress, after weeks of debate, has so far failed to pass additional coronavirus relief legislation after weeks of partisan in-fighting. Failure to pass additional legislation means funding for many programs, including those providing support to nursing facilities, will soon dry up entirely. In a Facebook Live event with NBC last week, Giroir acknowledged the tests being distributed to nursing homes are not as accurate as other tests but return results faster, which he said is a key tool to help quickly identify hot spots.

"It is much better to have a much less sensitive test that you get back within 15 minutes than a perfectly sensitive test you get back in three days," Giroir said.

Gail Bruno, a certified nursing assistant at a nursing home in South Florida that has seen a recent increase in coronavirus cases, says long-term care facilities did not receive access to testing or vital protective equipment fast enough.

"I'm tired, it's been months," Bruno said. "We have 23 residents who are positive right now and it is very, very scary."

In late July, the Department of Health and Human Services announced it would distribute $5 billion to nursing homes through the CARES Act Provider Relief Fund for Nursing Homes.

On Friday, the agency announced its plans to allocate these funds through an initial $2.5 billion distributed to nursing homes in mid-August to support increased testing, staffing, PPE needs, and COVID-19 isolation facilities. This will be followed by additional performance-based distributions throughout the fall that "will consider the prevalence of the virus in the nursing home's local geography, and will be based on the nursing home's ability within this context to minimize COVID spread and COVID-related fatalities among its residents," according to HHS.

For nursing home advocates like Toby Edelman, a senior policy attorney for the Center for Medicare Advocacy, the latest figures showing the persistence of the virus in nursing homes serve as a reminder of the challenges the facilities will continue to face.

"Nursing facilities do not have enough staff, tests, and personal protective equipment," Edelman said, adding that as a result, they "remain dangerous places, for residents and workers alike."

Copyright © 2020, ABC Audio. All rights reserved.

How widespread is COVID-19 in children? A look at the latest data as schools reopen

filadendron/iStockBy MEREDITH DELISO, ABC News

(NEW YORK) -- As schools across the country start to reopen, recent data shows that COVID-19 infection is on the rise in children.

The American Academy of Pediatrics, in collaboration with the Children's Hospital Association, each week surveys all publicly available data from U.S. states on child COVID-19 cases.

According to its most-recent report, as of July 30, there were 338,982 total child COVID-19 cases reported since the onset of the pandemic. That represents 8.8% of all COVID-19 cases.

In 25 states, 10% or more of reported cases were in children, the report found. The highest percentages were in Wyoming, Tennessee and New Mexico, with over 15%. New Jersey and New York City, meanwhile, had the lowest, with 3% or less.

The overall rate was 447 cases per 100,000 children in the population, the report found. Seventeen states and the District of Columbia reported more than 500 cases per 100,000 children, according to the report. Arizona had the highest rate, surpassing 1,000, while Hawaii had the lowest, under 100.

Overall, COVID-19 cases are on the rise in children: From July 16 to July 30, there was a 40% increase in child cases, the report found. The total number of cases, percentage of total cases and rate of cases in children are also the highest they've been since the AAP and CHA's first report, which examined COVID-19 data as of April 16.

However, COVID-19-related hospitalizations and deaths in children are "uncommon," and severe illness is "rare," according to the AAP. Based on data from 43 states and New York City, children made up less than 1% of all COVID-19 deaths. Twenty states have reported zero deaths in children, and these made up as much as 3.7% of total reported COVID-19 hospitalizations in 20 states and New York City, the report found.

The professional association noted that "states should continue to provide detailed reports on COVID-19 cases, testing, hospitalizations and mortality by age so that the effects of COVID-19 on children's health can continue to be documented and monitored."

The latest study looked at demographic data from 49 states, plus New York City, Washington, D.C., Puerto Rico and Guam. New York did not provide age distribution for state-wide cases, the study noted. Age ranges varied from 0 to 14 to 0 to 24, depending on the state.

Latest CDC data

The Centers for Disease Control and Prevention also tracks COVID-19 data by demographic, based on reports from U.S. states, U.S. territories, New York City and D.C.

As of Aug. 9, children under the age of 18 accounted for 7.4% of reported COVID-19 cases and less than 1% of reported COVID-19 deaths, according to the CDC. As of Aug. 1, there were 616 reported COVID-19-associated hospitalizations in patients under 18 -- nearly 1.4% of total hospitalizations.

Most children with COVID-19 are asymptomatic or have mild symptoms, according to the CDC.

The CDC is also tracking what they call the multisystem inflammatory syndrome in children (MIS-C), a rare but severe condition that was reported several weeks after the onset of COVID-19 in children and adolescents.

The condition may cause shock, gastrointestinal symptoms, cardiac involvement and elevated inflammatory markers, according to the CDC.

As of Aug. 6, 570 MIS-C patients and 10 deaths have been reported from 40 states, D.C. and New York City, the CDC found. The average age for kids affected was 8 years old.

Copyright © 2020, ABC Audio. All rights reserved.

Parents, teachers must work together to protect students from COVID-19

smolaw11/iStockBy Dr. MOLLY STOUT, ABC News

(NEW YORK) -- When it comes to safely reopening schools, there's valid cause for concern.

"We're a bit in uncharted territory, because we haven't had to reopen schools in the context of a pandemic," said Dr. Dan H. Barouch, director of Beth Israel Deaconess Medical Center's Center for Virology and Vaccine Research.

 Parents and teachers are asking what practical measures teachers and children can take to protect each other when in-person schooling resumes. Most experts agree they won't stumble upon a one-size-fits-all solution.

"It's very clear that virus transmission occurs in kids. Children can become sick from this virus -- not as frequently as adults, and certainly not as much as elderly individuals, but not all children have a benign course," cautioned Barouch.

"The first step needed for everyone to be safe this fall as kids return to school is for community transmission to be down significantly," said Dr. Edith Bracho-Sanchez, a primary care pediatrician and assistant professor of pediatrics at Columbia University Medical Center, who encourages families to familiarize themselves with virus levels in their community.

New York City Mayor Bill de Blasio has announced that the nation's largest public school system will permit in-person classes only if the positivity rate remains below 3%.

The decision to go back to school from a safety standpoint is weighing heavily on families and teachers.

"There are competing forces ... adults need to go to work and children need to have social interaction," Barouch added.

Bracho-Sanchez also encourages families to consider individual family circumstances when sending kids back to school, adding, "Take into account who is living at home, the ages of people at home and potential underlying risk factors of family members."

"Whatever decision a family makes, it's the right decision for that family," she added. "We need to validate what each family is going through and validate the decisions they're arriving at."

When it comes to keeping kids and teachers safe, Bracho-Sanchez encourages families to look for layers of protection at school and get to know the strategies that schools are implementing throughout the school day.

It starts with how your kids are getting to school, whether they're walking or being dropped off, although "that's not feasible for every family," said Bracho-Sanchez. For families sending their kids on the bus, it's best to "look for buses that are half-capacity with the windows open, where everyone is wearing masks."

Parents should be aware of mask policies at schools to help promote safety for children and teachers alike, as well as maintaining proper social distancing.

"Keep kids in smaller groups, so that if there is infection then there is a more limited number of exposures," Barouch said.

Experts emphasize that these small groups should be maintained inside classrooms, at outdoor recess and at after-school playdates. School lunches should be eaten at students' desks, not in crowded cafeterias.

Parents also must be vigilant about not sending a potentially sick child to school.

"It could be a little mild cough or runny nose, where in the past many parents would send their kids to school with these symptoms," Bracho-Sanchez said. "It's not going to be able to happen now. It will be a big cultural shift."

School policies supporting sick teachers are equally important, especially when it comes to providing paid leave, Bracho-Sanchez added.

Ultimately, it all comes down to a community's viral load.

"There are so many smart people, committed teachers, parents and public health experts who are working together to come up with all sorts of very smart strategies," Bracho-Sanchez continued, "but, unfortunately, if we don't set them up for success by first controlling the virus in the community, I don't think there are going to be enough layers that are going to keep this virus out of schools."

Copyright © 2020, ABC Audio. All rights reserved.

Vaccine nationalism: Experts warn countries against taking 'me-first' approach


(NEW YORK) -- As the race for a novel coronavirus vaccine continues, there's growing concern from scientists and economic experts that wealthy nations are prioritizing getting doses for their own citizens at the cost of poorer nations and thus failing to control the global pandemic.

Some countries -- including the U.S. and the U.K. -- are securing vast quantities of new coronavirus vaccine candidates in a phenomenon being dubbed "vaccine nationalism."

Now, a growing chorus of experts is sounding the alarm. They say that with a virus capable of quickly spreading from country to country, vaccinating one nation at a time will ultimately prolong the pandemic, lead to more lives lost and continue to devastate the world economy.

"The virus does not know and does not respect borders. An outbreak of the virus anywhere threatens people everywhere," Dr. Dan Barouch, professor of medicine at Harvard Medical School, told ABC News.

While it's understandable for each country's "health departments to have a primary responsibly to their country's citizens," Barouch said, "each country needs to have a dual goal -- a goal of protecting their citizens and also ... to do their part in solving the global pandemic."

Economists Thomas J. Bollyky and Chad P. Bown have said the fastest way to stop the pandemic is by breaking chains of transmission by allocating the vaccine to people who are the most likely to be infected -- no matter where they live.

"Global cooperation on vaccine allocation would be the most efficient way to disrupt the spread of the virus. It would also spur economies, avoid supply chain disruptions, and prevent unnecessary geopolitical conflict," they wrote in a recent editorial published in Foreign Affairs.

Yet, even if global cooperation is the most efficient way to halt a virus in its tracks, it's a difficult political proposition.

In the midst of this debate, wealthy countries have invested heavily in ensuring that their own citizens get the vaccine first.

"Prioritization of vaccine access can't be governed by political borders. This means health workers and the vulnerable deserve to be first in line regardless of nationality," said Dr. John Brownstein, an epidemiologist and ABC News contributor.

The U.S. has Operation Warp Speed -- a government-funded initiative to turbocharge vaccine development and secure vaccine doses for the U.S. population. In total, almost $10 billion has been allocated by Congress for hundreds of millions of doses to be made available to U.S. citizens.

In Europe, there is the Inclusive Vaccines Alliance which has already agreed to buy 400 million doses of AstraZeneca's vaccine being co-developed with Oxford University.

The U.K. has made a deal with AstraZeneca and Wockhardt to secure and distribute 30 million vaccine doses by September, part of a broader push to get 100 million doses by the end of the year. A deal has also been made for the Sanofi/GlaxoSmithKline vaccine.

Some have compared the coronavirus vaccine buyouts to the 2009 swine flu pandemic, when wealthier countries bought up of most of the vaccine doses. The U.S. and many European countries donated some of their vaccines to poorer countries, but only when they were satisfied that they had enough doses for their own citizens.

That's important, because a strategy of vaccinating high-risk people first -- wherever they are -- is thought to be most effective at slowing viral transmission.

"Ensuring fair, equitable and transparent allocation is not just the right thing to do, it's in everyone's best interest," Brownstein said. "Placing certain wealthy countries at the top of this list will only serve to prolong the pandemic."

There are also implications for vaccine cost. Countries "bidding" against each other could also increase the cost of vaccines for everyone.

Even countries that do secure large doses of vaccine candidates, the risk remains that the vaccine they bought simply doesn't work well enough. Some countries could be playing a potentially dangerous game by gambling on a small number of vaccines.

Although the World Health Organization has set up a group called the COVID-19 Vaccines Global Access, with a mission statement to guarantee "fair and equitable access for every country in the world," its lofty goals will only be realized with a formal and tangible commitment by powerful nations.

But like other global scourges, the burden of supplying a coronavirus vaccine to low-income countries is likely to fall to nongovernmental organizations like the Bill and Melinda Gates Foundation, and international vaccine collaborations it founded, such as the Coalition for Epidemic Preparedness Innovations and Gavi.

According to Barouch, nothing short of a global strategy will work to control the virus: "For a global pandemic, if the virus is not brought under control globally ... we will not solve the problem."

Copyright © 2020, ABC Audio. All rights reserved.

How experts would clean up our COVID nightmare if they were in charge

da-kuk/iStockBy ERIN SCHUMAKER, ABC News

(NEW YORK) -- With no end in sight for the United States' coronavirus outbreak, which has now topped five million infections and 162,000 virus deaths -- accounting for roughly a quarter of the world's fatalities -- many Americans are wondering if anything could help turn the tide.

The list of mistakes critics say the U.S. government has made is well-documented, including relying on a slow and patchwork state-led effort instead of a national plan; mixed messaging and politicization of key protective measures like masks; lack of testing and personal protective equipment for front-line workers; and decades-long defunding of America's public health infrastructure.

Many state and local governments have similarly faltered in their coronavirus response, delaying restrictions, pushing reopening despite cases not being on the decline and wavering on requiring masks.

Now, half a year after the first confirmed COVID-19 infection was reported in the U.S., the country is contending with surging caseload, hospitalizations and deaths which only started to level off this week. July, however, had almost as many cases as the first six months of the year combined.

President Donald Trump and the White House have pushed hard for reopening the country in the wake of the virus' spring peak, arguing that the economic damage of the shutdown, including leaving millions unemployed, outweighed other considerations. They have also largely blamed the increase jump in cases on increased testing, which they touted along with early measures like restricting travel from China.

They also have said that states got the supplies that they needed, including ventilators and personal protective equipment (PPE), although governors have disputed that claim.

Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention (CDC), which has also drawn criticism for being slow to ramp up testing in the early days of the outbreak, admitted that "there's been mistakes," in a previous interview with ABC News.

"Yes, we fail. We're in it doing the best we can," he said. "We're trying to make the best judgements we can."

Redfield also gave simple instructions for a way out.

"This virus can be defeated if people just wear a mask," he said.

Federal public health officials and state and local leaders have sent mixed messages on subjects like masking and who can and should get tested. The CDC, for instance, has been recommending mask-wearing since the spring, but initially suggested the general public didn't need to do so.

Trump, who was hesitant to wear a mask in public even as his public health officials insisted it was life-saving, began wearing one occasionally. Still, the administration has not issued a national mask mandate.

White House Deputy Press Secretary Judd Deere defended the administration's response in a statement to ABC News.

"The White House Coronavirus Task Force is providing tailored recommendations weekly to every governor and health commissioner for their states and counties," Deere said. "Local leaders are best positioned to make on-the-ground decision for their communities armed with CDC guidelines and best practices."

"The United States will not be shut down again," he added. "As the President has said, the cure cannot be worse than the disease."

Despite the grim numbers, experts at Johns Hopkins, RAND and New York University contacted by ABC News did not view the situation as hopeless. There's a way out, they said. But a COVID-19 escape hatch will require a degree of coordination and leadership they say appears to be in short supply among our nation's decision-makers.

Here's how four experts say they'd clean up the United States' COVID-19 nightmare, if they were charge:

How would you rate the U.S. COVID response?

Dr. Amesh Adalja, senior scholar, Johns Hopkins Center for Health Security:
From the start, there has been wide-scale evasion from the highest levels of government. The first U.S. steps solely focused on China in terms of who could be tested and included an unnecessary travel ban. The failure of testing capacity, which we still suffer from today has completely destroyed the outbreak response. In the early days, it was impossible for university and private labs to make test kits because we had to rely on a flawed CDC [Centers for Disease Control and Prevention] kit. Throughout the pandemic there has been a general attack on expertise in a touting of unproven medications to the detriment of evidence-based medicine.

Dr. Jennifer Bouey, epidemiologist, senior policy researcher at RAND: How the U.S., as the richest country in the world, and leader of global health for many decades, has failed so miserably was surprising to many public health professionals. Six months after the first COVID case, the virus is still roaming around freely in the U.S., causing 50,000 cases and over 1,000 deaths each day. This is mind-boggling. At least we have a reporting system and a transparency policy that can more or less provide an accurate picture of the epidemic. The treatment improvement and vaccine development are on track, but I am reluctant to call it "U.S." response. It's more a credit of scientists and physicians.

Cheryl Healton, dean, NYU School of Global Public Health: We've botched almost everything except for vaccine development.

Dr. Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health: The U.S. is clearly doing much more poorly than many countries in the world. Not just countries with similar levels of economic development, but also we're doing more poorly than many smaller and less well-resourced countries.

What key policy changes would you make to turn the U.S. outbreak around?

Adalja: The most important change would be to allow the CDC to do its job and act unfettered. I would suggest that the White House step back from this. From the start, the CDC has had to express fealty to the president’s whims and unreality rather than the actual facts on the ground.

Inglesby: The progress we made early in the pandemic was lost in the following months. We need universal adherence to fundamentals like masking, physical distancing and hand hygiene, and no large gatherings. We also need clear, consistent and unified public health messaging from national and state governments. I'd shut down high-risk activities in places experiencing disease surges and if hospitals are in crisis, I'd implement stay-at-home orders for two weeks. I'd expand PPE [personal protective equipment] production and distribution and accelerate testing to shorten the turnaround time to one day.

Bouey: The premature opening and incoherent policy has wiped out the gains on the capacity of testing and tracing from the first widespread shutdowns. Now the virus is a wildfire, spreading freely in every corner of the country. I would propose a 90% shutdown of the whole country for three weeks. No travel, no work, no school, no going out unless for emergencies and health care. We wait out the virus cycle, then gradually reopen with intensive testing and tracing. We quarantine people who test positive and set up a sensitive surveillance system to identify hotspots. This would allow a semi-opening in two to three months (still no big gathering or bars) and relatively normal life with vigilance in six months.

Healton: We should shut down states with rising cases for two weeks to give the health system a breather and to lower the state's baseline rate so that contact tracing is more viable. We should strictly adhere to the CDC reopening and pullback guidance with one modification -- a national mandatory mask law.

What long-term action would you take?

Adalja: Pandemic preparedness has be prioritized in the same fashion as national security. This can't be something that goes through a cycle of neglect and panic, but something that is sustainably funded and supported even when infectious disease emergencies recede from the headlines.

I’d write public health funding, pandemic response and public health data tracing during a pandemic into law. We have to improve the infrastructure by building a consistent national medical record platform; linking travel records to health data; building a public health workforce; streamlining public-private pandemic preparedness partnerships; and moving critical manufacturing capability back to U.S. We need to shift leadership in a pandemic to experienced professionals.

Healton: The U.S. spends less than 1% percent of every health dollar on public health. We need to invest more, bring back the White House global pandemic team. We need to reinvigorate the CDC and cushion it from politicization. We need to address the delegation of public health to the local level and make explicit federal obligations and authority in a pandemic.

Is your plan realistic? What are the biggest obstacles to it?

Adalja: The biggest obstacle to my plan is the fact the politicians are short-range thinkers, who only think about the next election and not about the long-term consequences of their actions.

Inglesby: It's all feasible if national and state leaders get fully behind it.

Bouey: Incompetent leadership, politicizing the pandemic and complacency are the biggest obstacles. We need leadership that can provide coherent, effective, science-based messaging to the U.S. public. That leader needs to provide the facts of the epidemic, lay out a plan and urge Americans to work together to fight the virus, instead of fighting each other. We have to stop congratulating ourselves, or blaming others, and face the reality that there's a lot of work to do to restore public health and mend the health care system in this country.

Healton: The White House resistance and the public's lack of understanding.

If your COVID-19 recovery plan were implemented immediately, where do you anticipate United States’ would be six months from now?

Adalja: We'd be thinking about pandemic preparedness strategically and actually implementing the systems needed to increase our resilience. I'd immediately remove restraints on the CDC. That would be a major short-term benefit for our national testing and public health communication strategies.

Inglesby: Many other countries have shown it is possible to bring disease down to very low level. It is possible.

Bouey: In my view, the only plan that can ensure a six-month virus containment will be a three- to four-week complete national shutdown, in a more restrictive way than last time, followed by testing, tracing, patient isolation and travel quarantine. In the short term it's painful, but otherwise there's no possibility of even half-opening for schools, businesses and gatherings.

Healton: The U.S. can sharply cut the infection rate, but only with with another shutdown in rising states. This makes both economic and public health sense. Without evoking emergency production capacity, we will not meet the CDC testing criteria, and thus cannot meet contact tracing guidelines.

Anything else you want Americans to know?

Healton: This is a national tragedy of epic proportion, and sadly, a national embarrassment, too. COVID-19 is not an equal-opportunity killer. Our racism is on stark display.

These interviews have been edited and condensed for clarity.

Copyright © 2020, ABC Audio. All rights reserved.

New study finds 1 in 9 women reported drinking alcohol while pregnant

juankphoto/iStockBy DR. MOLLY STOUT, ABC News

(ATLANTA) -- It has long been known that alcohol and pregnancy can be a dangerous combination. Now, a new study from the Centers for Disease Control and Prevention finds one in nine women reported drinking while pregnant.

Drinking patterns were broken down by trimester of pregnancy, with the study finding that nearly 20% of women drank in their first trimester. But it found this rate dropped to 4.7% of respondents in the second and third trimesters.

“Given that we live in a society that knows about the risks that come with drinking, it is alarming that this is a statistic,” said Dr. Jessica Shepherd, an obstetrician-gynecologist at Baylor University Medical Center in Dallas, who added that most women will stop after a positive pregnancy test.

The CDC report also observed specific drinking patterns such as binge drinking four or more beverages in one occasion, which was reported in more than 10% of respondents during the first trimester.

The study, from this week’s CDC "Morbidity and Mortality Weekly Report," highlighted data from the National Survey on Drug Use and Health (NSDUH), run from 2015 to 2018, that observed, among other habits, patterns of drinking and drug use in pregnant women.

But many OBGYN’s state that any self-reported drinking figures are likely an underestimate, because people tend to report drinking fewer alcoholic drinks than they actually consume. Experts cite one of the most common reasons women may report alcohol use in the earliest stage of pregnancy is because it occurred before they knew they were pregnant.

In 2016, the CDC revised its statement on alcohol use in pregnancy to include women before they even became pregnant.

But the report was met with mixed reception, with many citing the unrealistic expectation that any woman of childbearing age who could become pregnant should refrain from drinking to prevent possible harmful effects.

“Most pregnancies, if you look at the statistics, are unplanned, so people might not know that they’re pregnant until six or seven weeks … and there could be alcohol consumption during that time,” explained Dr. Shepherd.

In another recent study, published by Dr. Katherine Hartmann at Vanderbilt University, her research group followed pre-pregnancy habits of thousands of women week by week extending into their second trimester and tracking rates of miscarriages. They found that even a rare drink in the first few weeks of pregnancy could have a disastrous effect.

“We were able to take into account the type of alcohol that they used, the intensity of their drinking, and week by week, what their self-reported exposure was,” Hartmann explained.

“When they stopped [drinking] right around the missed period, they still had a 37% increased risk in [miscarriage] for those weeks of exposure.”

This was also seen at very low levels of drinking. “Women who had an average of less than one drink per week over the course of a month were still at elevated risk, which floored me,” explained Hartmann.

And the risk was cumulative.

According to Hartmann’s study, each additional week of alcohol exposure during pregnancy was associated with an 8% relative increase in risk of miscarriage compared with women who didn’t drink.

The CDC report found past drinking within the last 12 months was reported by nearly two-thirds of pregnant respondents.

Possible solutions to help women close the gap between knowing they’re pregnant and stopping their drinking? "Iif we had cheaper pregnancy tests that you could pick up at your community health clinic like you could pick up condoms," said Dr. Hartmann, "this problem with alcohol exposure leading to miscarriage or fetal alcohol syndrome could be really remediated.”

“I think more education should go into family planning,” stated Shepherd. “If they want to conceive, they should discuss with their doctor beforehand and if they know they’re planning, they can stop drinking alcohol ahead of time."

Copyright © 2020, ABC Audio. All rights reserved.

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