Health Headlines


(NEW YORK) -- As the nation moves towards recovery and reopening, one emerging reality in the aftermath of the coronavirus outbreak is that the American health care system will see its own new normal in the coming weeks and months, according to experts and doctors.

Strapped for cash and some protective equipment, and forced to re-write protocols to better fortify against the contagious spread of COVID-19, doctors’ offices and hospitals across the country are beginning to rethink their approach to personal care -- from an increase in telemedicine and widespread coronavirus testing for patients, to the complex math about which procedures should go ahead and how.

“This is an opportunity to ask, what do we really need to do and what do we need to not do,” Robert MacLean, former president of the American College of Physicians, told ABC News. The pandemic “has gotten us back to doctoring. We need to take advantage of that and critically look at the utilization of lot of things we have done.”

While virus patients flooded into some hospitals, elective and other non-emergency surgeries came grinding to a halt, causing drastic financial strain on facilities big and small. Now, as with the rest of the country, doctors have cautiously started to resume those procedures.

As of this report, at least 30 states have reportedly relaxed mitigation strategies related to surgery, and it appears more are on their way.

University of Michigan Health System has reopened its elective surgeries, but officials there said they are unsure how long it will take for the hospital to be ready for the old pace of activity.

Dr. Andrew Ibrahim, a general surgeon at University of Michigan, said physicians there are weighing the benefits of each surgical procedure against the risk of COVID-19 and the resources available. The resumption of procedures so far has been gradual.

“We've brought back surgery slowly based on their time-sensitivity in line with [Michigan] Gov. [Gretchen] Whitmer's orders,” he said.

Ibrahim said the hospital created a central committee to prioritize which cases need more urgent attention, relying on specialists to help triage the cases.

In Nebraska and Kentucky, hospital administrators and physicians like Dr. Prakash Pandalai, a surgeon at University of Kentucky, said they started by prioritizing cancer operations, surgeries needed to prevent loss of a limb, and procedures needed to prevent further acceleration of disease.

"But we need to be careful about ensuring that there is enough protective equipment for providers and patients as we come back online," Pandalai said.

'Watching PPE supplies and flow very carefully'

As Pandalai indicated, beyond the urgency of the procedures for patients, one limiting factor is the supply of personal protective equipment, better known as PPE, that became such a focal point as the coronavirus spread.

PPE is not necessarily the same for various surgeries as it would be to treat COVID-19 patients, but there is enough of an overlap in basic protective equipment that health care officials told ABC News they're taking careful note when considering the amount of PPE that would be expended for a particular operation and how much PPE they might need if a resurgence of COVID-19 strikes.

Jeffrey Tieman, president and chief executive officer at the Vermont Association of Hospitals and Health Systems, said that if hospitals "don't feel confidant in PPE supply, you need to think about whether you can continue to offer those elective procedures."

Dr. Kat McGraw, physician and chief medical officer at Brattleboro Memorial Hospital in Vermont, said that since the state has allowed outpatient surgeries to resume, the hospital has been "tasked with that responsibility of being able to self supply surge PPE if we want to be able to go forward with elective procedures."

McGraw said the hospital has developed its own stockpile of PPE for an emergency, which she compared to a blood bank.

"We have been purchasing not through our usual streams, but trying to find creative ways to get augmented amount of PPE, but thats not necessarily sustainable," she said. "The trick to moving forward with surgery is making sure it doesn't impeded with our ability to have everything in place for our ability to manage a surge for COVID-19."

Dr. Brandon Mauldin, the chief medical officer of the Tulane Health System in Louisiana, referred to this dilemma as a "balancing act."

"Because we have initiated and started back on elective surgeries as [COVID-19] patients have declined, the balancing of it is a lot easier to do," Mauldin told ABC News. "So we feel more comfortable that we have sufficient PPE."

Others are not as confident. Dr. Sharmila Makhija, chair of OBYGN at Montefiore Medical Center in the Bronx, said she and other colleagues "across the country" are "worried about whether we have enough personal protective equipment to do elective surgeries."

Somewhere in the middle is Providence Health, which serves urban and rural communities from Alaska to Southern California. The chief value officer there, Dr. Joanne Roberts, told ABC News they are "watching PPE supplies and flow very carefully as we resume non-emergent procedures."

Remote screenings and coronavirus tests as pre-op

One strategy to save on PPE, as well as improve general safety amid the coronavirus spread, is the increasing use of telemedicine -- what one doctor said may become a pre-operation "new normal."

Dr. Aleaf Worku, at CareMore Health, said it will be more likely that patient assessment -- the initial practice of seeing what kind of care a patient needs -- could be done remotely, sparing the patient a visit to the hospital and sparing medical professionals from coming in physical contact with the patient.

“This is why telemedicine may be the way we do pre-op screening in the new normal,” Aleaf said.

Another potential new normal for pre-op? COVID-19 testing.

That's the strategy McGraw said her Virginia hospital has adopted. Patients coming in for surgery are tested 72 to 96 hours in advance of the procedure and are required to self-isolate during that time.

She said patients should think of this as part of the new standard "pre-op" steps that so many have come to know before going in for any sort of procedure, which often include precautions such as refraining from eating or drinking for 12 hours.

"Now, everybody needs their [coronavirus] test," McGraw said.

Doctors at hospitals in California, Texas, and Louisiana said they are doing universal testing for patients scheduled for surgeries.

The testing "gives reassurance to both patients and providers, even beyond just doctors nurses, that we are doing all we can to create a COVID-safe environment," said Dr. Loren Robinson, who practices at Christus Health in Texas.

But protocols are not the same, even within the states. Dr. Quyen Chu at Oschner LSU Health in Shreveport, Louisiana, said the hospital is doing universal testing for patients undergoing elective procedures, but Mauldin at Tulane said his hospital system in Louisiana hasn't quite gone that far.

Patients and doctors there are working together to determine if testing is necessary on a case by case basis, Mauldin said. The hospital has taken other precautions, including universal masking and staggered patient appointments.

As hospitals feel financial pinch, COVID-19 sparks larger questions

Beyond the staggering human suffering, another casualty of the coronavirus' spread is the financial stability of hospitals and other health care facilities at a time when many are needed most.

Some hospitals are in dire trouble, despite billions of financial support to the industry from the federal government.

“One sad reality is that smaller or stand-alone hospitals may have lost too much revenue the last two months to remain viable,” said Ibrahim.

Physicians interviewed by ABC News predicted a wave of hospital closures could strike this summer.

"How is it possible for hospitals to be so vital at the same time they're so vulnerable and what is the solution in the new normal?" asked Deb Gordon, a consumer health advocate.

For those that survive, like many belonging to larger systems that have multiple hospital locations, health care officials said COVID-19 may be the catalyst for asking and answering bigger, long-term questions related to what's called value-based care, a philosophy that seeks to change how much is spent on health care as a nation and improve outcomes. The approach prioritizes keeping people healthy rather than having to deliver and pay for avoidable and unnecessary care that is inefficient and may not improve health.

For example, in the aftermath of the coronavirus, health systems may be more willing to reorganize care so it meets patients where they are at in their health journey and keep them safer, such as ambulatory surgery centers and improved care at home.

While the moves can also make sense from a financial perspective, experts warned they will need to be balanced against potential safety concerns.

Value-based care also prioritizes chronic disease management, a significant issue that has been exposed during the pandemic. Those with chronic diseases are more likely to have worse outcomes if they contract the coronavirus.

Telemedicine and remote patient monitoring could allow for better management of chronic diseases earlier and prevent patients from showing up in a healthcare setting that can potentially expose them to the virus.

"It is a fascinating time. The opportunities are huge," Providence Health's Roberts said.

But for all the changes hospitals could make, much is going to depend on whether patients feel comfortable enough to come in at all. ABC News has reported that people are foregoing in-person consultations of even potentially serious conditions for fear of COVID-19.

"We did just complete a patient sample survey of 12,000 volunteers, and the biggest barrier does seem to be their fear of getting COVID in our facilities. Only 18% say they feel safe going back to clinics, [emergency rooms], or hospitals," Roberts told ABC News.

With the new safety measures, hospitals and doctors across the country hope to change that.

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) -- The headaches came first. "Terrible" migraines that would last throughout the day.

Osmond Nicholas, then 26, was working as a police officer in his hometown of Oceanside, California, after earning his Bachelor's degree in criminal justice and his Master's in homeland security at San Diego State University.

 While out on the job in May 2017, the former college football player had what he described as "a little blackout" moment while driving his police car. He said he remembers questioning where he was at the moment, and his partner at the time reminded him, "Oh, you're driving right behind me."

The headaches and blackouts persisted. Soon he was sleeping up to 16 hours a day.

In July, after multiple doctors told him it was likely fatigue due to his graveyard shift on the police force, he received a diagnosis that would change the course of his life.

Nicholas was diagnosed with stage 4 glioblastoma multiforme, a rare disease that experts say is among the deadliest type of brain cancers. The aggressive cancer affects an estimated 13,000 in the United States every year and is not curable. Sens. John McCain and Ted Kennedy were both diagnosed with and ultimately died from the disease.

Bachelor party plans end up in the emergency room

Before receiving his brain cancer diagnosis, Nicholas said he thought the migraines and chronic fatigue were due to his "work schedule or diet." He changed his diet to see if that would make a difference, but the migraines continued.

"Finally I said, you know what, maybe I am behind in sleep. I went to a doctor, and he kind of gave me the chronic fatigue syndrome diagnosis," he said.

But Nicholas didn't understand the diagnosis because he felt like he was getting plenty of sleep.

In June, Nicholas was planning to go to Las Vegas for his bachelor party with some friends. He had proposed to his then-fiancée Trinity Daniel in June 2016, and the two were planning to get married in September 2017. At his parents' home the night before his trip, he experienced an extremely painful headache.

"That was the worst headache I ever had, which led to nausea and me waking up vomiting," he remembered.

His mother, a nurse practitioner, insisted they go to the hospital immediately.

Within an hour while at the emergency room at Kaiser Permanente Zion Medical Center in San Diego, Nicholas was told that a CT scan showed he had a mass in his brain.

"I didn't know what mass was, or I didn't put two and two together -- mass, tumor, cancer," he said.

"I was actually excited at this point because for half a year I'd been feeling like I was crazy with these headaches," he continued. "Finally they had found something that I wasn't crazy, and everybody was believing me."

Grasping the reality of his diagnosis

After discovering the mass, Nicholas was told he would have to have emergency surgery that morning. He said the immediacy of the surgery didn't allow him time to digest any of the information.

"At that point, I hadn't even really put cancer in any of this," he said. "I just thought, OK, I got a tumor, or a mass. The worst part at that point was them doing a craniotomy and opening my skull."

After the surgery, he thought he was "over the largest hill."

"I was pretty sure that they were going to call me, say no news is good news ... and that did not happen," he shared.

He remembered telling his boss that he could come back to work in a few weeks after the staples were removed from his head.

Two weeks post-operation, Nicholas had his first oncology referral appointment in July 2017. There he was told that he had brain cancer, specifically stage 4 glioblastoma, which he described as, "a bunch of words," to him at that point.

"I was probably a little naive, even after having brain surgery, I was of the mindset that people always have benign brain tumors all the time, or benign tumors, I always see it on the news," he said. "That's the extent of it. They take something out of my head, I'll have to deal with the ugly scar, and I'll be back to work."

His mother asked about his prognosis in the appointment after hearing the diagnosis.

"That's when the doctor kind of reluctantly, but truthfully, told me the average can be anywhere from 12 to 18 months, but that I was lucky that I got the tumor out," he said.

Although glioblastoma is more common with older adults, the disease affects patients of all ages.

"A lot of research is ongoing trying to understand why these tumors develop and so far, with very rare exception, there does not seem to be any link with environmental exposure, nor with any link for an inherited or genetic predisposition to the development of these tumors," Dr. David Reardon, clinical director, Center for Neuro-Oncology, Medical Oncology, at the Dana-Farber Cancer Institute, told ABC News' Good Morming America.

"For the vast majority of patients, this is a type of cancer that develops for reasons we don't understand and is not due to anything they did, or were exposed to or inherited," Reardon, who has no connection to Nicholas' case, said.

With survival rates varying by several prognostic factors, including age, tumor stage and more, the median survival rate is estimated at 15 months for patients with glioblastoma, according to Reardon.

Dr. Michael Vogelbaum, chief of neurosurgery and program leader of the department of neuro-oncology at Moffitt Cancer Center, said for patients who receive "very intensive and highly monitored care" the median survival ranges from around 16 to 20 months. Vogelbaum has no connection to Nicholas' case.

Nicholas said the day he received his diagnosis was "probably one of the hardest days" of his life.

"I literally thought, I'm young, I have cancer -- that means they could probably give me the most chemotherapy and most radiation and I'll be fine," he said.

"Then my oncologist later broke it down that this is not that type of cancer; It's a terminal cancer," he remembered. "Sometime sooner or later it will come back."

He remembered crying and not wanting to tell his diagnosis to his fiancée, who had just graduated from law school and was studying for the bar exam.

"I just wanted to come back home and report good news ... All I was seeing was that they give you 12 to 15 months ... and they lost their frame of speech ... their sense of way," he said about his research on the disease.

Nicholas called up his close friends to tell them he, "probably wouldn't be here much longer" after hearing the news.

"When you're so young, just hearing the word 'terminal' means you're gonna die ... I couldn't even mask how that was," he said.

Daniel, Nicholas' then-fiancée, now-wife, said the time was "extremely hard" as a young couple and changed their perspective on life.

"We definitely had our sad days where we would just sit around the house and cry, or one thing we used to do together is, which we still do now, we go on really long walks," she said. "We would just kind of talk about how we were feeling. At first, it was hard, but he is a fighter. He is someone who is committed to living."

Moving forward with treatment

Nicholas started his treatment with the standard of care for brain cancer patients. Following surgery, he started Temozolomide, or Temodar, a form of chemotherapy, combined with radiation at UCSD's Moores Cancer Center in August 2017.

But his body did "not respond well" to the chemotherapy.

"During radiation, my blood work, which are all my white blood cells, platelets and red blood cells, took a dive, which happens because that's what chemotherapy does," he said.

"Typically they take you off of that for a couple of weeks, it comes back up and then you restart your medication, but mine went so low," he continued. "I remember my platelets were in the single digits, which could cause you to start hemorrhaging and your body basically to die from that."

Nicholas had to discontinue chemotherapy after four weeks because of his body's reaction. He was nearly halfway through his 30 radiation treatments when his doctor informed him that he was "extremely anemic" and he had a very weak immune system.

He remembered getting short of breath from time to time, and his doctor told him, "'You have no immune system ... all your neutrophils are at zero, so be careful. Don't go outside.'" The next day, Nicholas got a fever and went straight to the emergency room at Kaiser Permanente Zion Medical Center, where the medical staff placed him in isolation on the oncology unit.

Nicholas was set to get married the next month, on Sept. 9, 2017, and had to stay quarantined on the oncology floor of the hospital for nearly three weeks.

"Up until September, I think third or fourth, they had to wait till my white blood cell neutrophil count got to at least 500 before they could release me out into the public. I remember, at that point, thinking that I was going to cancel my wedding because I was stuck in a hospital," he said.

His neutrophil count slowly rose, and he was finally released from the hospital three days before his wedding.

He hasn't done chemotherapy since, though he did finish his radiation treatments. The primary treatment he has relied on since September 2017 is Optune, a cap that he said he wears up to 23 hours a day.

Optune is a device used to treat glioblastoma that, "uses technology called 'tumor treating fields' to deliver electric fields to the brain, which can help stop the proliferation of cancer cells," according to the Mayo Clinic.

Although patients using Optune do not feel any of the electrical impulses from the treatment, Reardon said the treatment takes a "fairly motivated patient" because it should be worn at least 18 hours a day.

"We know from laboratory research that cancer cells, they tend to grow and divide in a very dysregulated and rapid way compared to normal cells in our body," Dr. Reardon explained. "When cancer cells are exposed to these oscillating electrical fields, it makes it very hard for the cells to split in two and divide. Eventually, if they can't do that the cancer cells give up and die."

When Nicholas first learned about the Food and Drug Administration-approved device, he recalled thinking, "If the cap's going to make me live longer, I'll shave my head and we'll do what we have to do."

Along with Optune, Nicholas continues getting platelet transfusions and white blood cell shots to boost his immune system. His blood work is checked every two weeks now and he has scans on his brain every six weeks.

"That's really in my life the only time that I really get an active reminder that I have brain cancer," he said on the scans. "Those couple days between getting your MRI ... and your doctor calling you back are probably the more nerve wracking days of your month."

He said he is aware of warnings from doctors about the unpredictability of the tumor.

"It could go away ... you don't have anything for 10 years, and then 10 years down the road, something pops up and you have a recurrence of all these cancer cells ... or it could be really quick. But what they do know is that right now ... it will come back."

Reardon said glioblastoma differs from other aggressive cancers because it does not metastasize throughout other body systems.

"Although we don't have to worry about the cancer spreading to the lungs, or bones, or lymph nodes, or the liver -- other organs in the body -- it does microscopically spread outwards," he said.

"The main mass that we can see on an MRI scan of the patient when they come in with their deficits or headache procedure, we see a localized mass on the MRI scan, extending outwardly from the mass are microscopic infiltrative cells that are moving outward into the adjacent brain tissues," he continued. "So although it doesn't metastasize and spread out of the brain, it does spread within the brain itself."

Life as a father and husband with brain cancer

Choosing to have a family, Nicholas says, was one of the biggest decisions he made in prioritizing living over his diagnosis.

"I didn't really know if I wanted to go through with getting married and put my wife [through becoming] a widow and have a daughter and let her grow up without dad if things went south or how they said it's supposed to go," he said. "It was kind of my first leap of faith that I'm going to live my life and live without boundaries and not let cancer take me a day before."

"I believe if I would have said, 'Hey, I don't want to have a baby or anything,' just the stuff that me and my wife kind of planned for -- that we knew we both wanted -- then I'd be letting cancer win that battle of me living my life," he added.

Daniel said she was hesitant to have a child because of her worries about her husband's illness. "I don't want to do this by myself," she remembered thinking. However, she said she and her husband built an even stronger bond early on through their struggles.

"Having such a big test early on in our marriage ... we kind of built the foundation that we're going to stick through this and stick together and whatever comes our way we can figure it out because we've been figuring it out ever since then," she said.

The couple welcomed their daughter Riyah in November 2018, and Daniel said their little girl and her father are inseparable.

"He was more excited, I think, to be a dad, especially when she was born," she said. "I work usually outside of the home, so he's the one that's here with her during the day. He does everything -- meals, diapers. I credit him with her learning how to walk and talk because I wasn't there and she was home with him."

"She's his little roadie, she goes everywhere with him," Daniel added. "They go on hikes, to shopping, to his friends' houses. Anywhere he goes, she goes and he is an amazingly doting father."

After retiring from the police force in October 2019, Nicholas said he has time to devote to his daughter.

"I just try to even think of it this way -- even if I do go in five years, six years, which I'm hoping I don't ... there are kids out there and little daughters out there that don't have many days with their father -- and he's alive. So I say, hey, now I can give her all my time," he said.

"I'm sure there's going to come a time when she's going to ask about everything, and I think I'm just going to keep it frank and honest because I think that's the best way to go about it," he added.

He said he has trouble putting the joys of fatherhood into words and encourages anyone considering having children to do so, with or without illness.

"If you're thinking about it, no matter how bad it is ... it'll be all right," he said. "Whether you're here or not -- just don't let don't let cancer dictate the rest of your life before it has to."

Nicholas is also fortunate to have parents supporting him at all times, he said.

"My mom and dad, they've been to every appointment. They also have been rocks in my life as far as just opening my eyes to just surviving really," he said.

His two siblings, Javier Nicholas, 30, and Nadya Hall, 34, have been with him throughout his fight as well.

His older brother Javier Nicholas said he's "extremely proud" of Osmond.

"He could have given up and nobody would be able to fault him for that, but he never did," he said. "His life changed forever in one day and he has always handled it like a warrior. He's my hero and an inspiration to those fighting their battle with brain cancer. As his brother, I love him and am truly inspired by his determination and grit."

Along with relying on the support of his family, Osmond Nicholas also uses music as an outlet to cope with his pain.

"Once I got out of the hospital and was able to play, it just took me away from the diagnosis for a moment and got me into a different zone of saying just appreciate the music and appreciate that you're here and you can still do the things you love to do," he said.

He said he now shares videos of his guitar playing on Instagram to bring hope to others who might also be fighting glioblastoma.

"I put up more videos not because I think I'm the best guitarist, trust me, I know I'm not, but because I know there's somebody else with glioblastoma, or whatever type of cancer ... that can get encouraged. Because I do think your attitude makes up a lot of how you fare because your mental health needs to be right," he said.

"I don't like to post too many sad things -- not that they don't happen -- but I think it just could be an inspiration that hey, if this guy with a brain tumor is enjoying life, what do we really have to be upset about?" he said.

Raising awareness and living every day to the fullest

The month of May is National Brain Cancer Awareness month, and Nicholas said he believes there is a desperate need for more awareness around brain cancer, specifically glioblastoma.

"I don't think many people think of, know what a glioblastoma is or really know much about brain cancers in general," he said.

Nicholas said living with brain cancer gives him the responsibility to share his story and hopes others battling the disease will do the same.

"I'm always going to be an ambassador for it," he said of his illness. "I just think speaking out on it would help out and then being as active as you can, whether it's to your hospitals or down to the senators to get money because funding is where big things actually happen."

Vogelbaum said research for glioblastoma treatment is difficult for several reasons.

"There's really no other area of cancer drug development where you don't take samples of treated tissue to understand what the treatment is doing," he said. "It's harder for us to do that in glioblastoma patients, but that is still necessary nonetheless."

He said "direct delivery of therapeutics to the brain" is also necessary.

"There needs to be an understanding that there is no way to establish a timeline to success in any field of medicine, particularly in cancer," he explained.

Vogelbaum said that in past decades, melanoma was the other untreatable cancer that produced many "terrible and unpredictable outcomes."

"Then along came immunotherapy and targeted therapy, BRAF targeted therapy, and that's completely changed the way that we approach melanoma, to the point where for many patients now it's a very treatable disease," he continued. "That happened in a very short time when there were a lot of other things have been tried and failed. Eventually, the right thing was found. We have to have the same kind of optimistic approach to glioblastoma."

He said researchers must continue to keep trying new approaches to further understand the biology of this cancer.

Nicholas' diagnosis has completely changed his perspective on life.

"I've become a little more introspective and just become much more at peace with life in general," he said. "Some people focus on, 'Oh, I just want to live to 100 years' and all that. I feel like being diagnosed with glioblastoma ... I just want to live to have a great day today and live as long as I can. Just to take advantage of that."

His illness has also reinforced his understanding of the fragility of life.

"The only thing I can guarantee is that we're all going to die, so use what you have," he added. "There's a little thing that we used in the brain tumor group, we call like, 'the best group that we never want to ever be a part of,' and I totally wouldn't want to be a part of this group if I could not, but since I am, it has changed my life."

"I don't think I see things rosier, but I think I see it more as the perspective of it all comes back to -- you can die any day, so live your life for each day, every day," he said.

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) — Guidance on non-essential travel from the Centers for Disease Control and Prevention (CDC) has not relaxed because summer is upon us. "Travel increases your chances of getting infected and spreading COVID-19," the agency notes on its website. "Staying home is the best way to protect yourself and others from getting sick."

But with states across the country reopening and more Americans leaving home than they were in early April, it's all but inevitable that some will test the waters with a vacation or weekend away this summer, even if those trips look different than in previous years.

Can Americans vacation safely during a pandemic?

Experts say there's no way to completely eliminate your risk of contracting COVID-19 while traveling. But there are precautions you can take to reduce your chances of getting COVID-19 or sickening others while vacationing.

First the ground rules. If you're leaving your community, never travel if you are sick or have been exposed to someone with COVID-19, the CDC warns. Similarly, you shouldn't travel with anyone who is sick or who has been exposed to the virus.

And if you're coming from a high-transmission area, there's a chance you might be an asymptomatic carrier. Take extra precautions to avoid spreading the virus to an area that hasn't seen many cases yet.

Spontaneity is not your friend this summer.

Bring a face mask to wear in public places. Plan ahead by packing food and water, in case restaurants and stores are closed, as well as enough hand sanitizer and medicine to last you for your entire trip. Check the guidance of the state and local health departments in your planned destination and along your route before you leave. State or local governments may have stay-at-home orders in effect, mandated quarantines upon arrival (Hawaii for instance), or checkpoints at state borders. Follow those instructions accordingly.

Will this be a normal summer? "Definitely not," said Joseph Allen, assistant professor of exposure assessment science at the Harvard T.H. Chan School of Public Health.

"And it also shouldn’t be," he added.

With those basics in mind, here's how you can vacation as safely as possible this summer, experts say.

At the beach or park:

Since the virus that causes COVID-19 is harder to transmit outdoors, outside spaces, including beaches, parks and hiking trails are good options for Americans who have been cooped up in their homes in apartments all spring.

But since those areas can also easily become crowded, it's still important to stay 6 feet from others and practice social distancing, even while outdoors. Practice universal mask wearing when social distancing is not possible.

Many popular national parks that closed in response to COVID-19 are reopening, which worries advocates, who are concerned about an influx of out-of-state visitors and limited park staff trying to enforce social distancing.

The risk of crowding is real, Allen explained, and Americans should be prepared for it.

"The burden is not just not the parks and park rangers, but it’s also on people," he added. Maintain physical distance between yourself and others, and if you need to pass within 6 feet of someone, put your mask on.

The same goes for beaches, most of which haven't previously had to manage flows of people the way that parks have. Beaches may want to set up walking lanes, so that people aren't threading through blankets at close range and reduce available parking spaces to limit density on the beach. Many places with beaches are already taking action to reduce density.

If crowded beaches need to turn visitors away, Americans should accept that they may not be able to go to their favorite beach on a certain day, Allen explained.

"We should view loosened restrictions on parks and beaches as a privilege that will be revoked if crowds don't act appropriately," he said.

"People are going to have to act responsibly," he added.

As for the ocean itself, experts are say that the risk lies with transmission between people. There's no evidence that the virus can be transmitted through water.

At the pool:

The CDC has new guidance for using public pools as swimming facilities across the country begin to reopen for the summer.

While on the pool deck, bathers should keep their masks on and avoid gathering in groups, according to the CDC. Lifeguards should focus exclusively on water safety, and other staff members should be assigned to enforce social distancing rules.

If you visit a public pool, stay 6 feet from others on the pool deck. While swimming, remain 6 feet away from anyone you don't live with.

The only time you should take off your mask is while you're in the water.

"Cloth face coverings can be difficult to breathe through when they're wet," the agency said in its recommendation.

Again, there is no evidence of transmission of the virus through water and public pools are generally chlorinated.

When renting a car, boat, hotel room or AirBnB:

Do your research. Call ahead and ask what the company or host is doing to sanitize between guests.

"What special precautions are they taking?" asked Jack Caravanos, a clinical professor of environmental public health sciences at NYU's School of Global Public Health. Compare options and choose the company you feel most comfortable with from a safety and hygiene prospective.

Specifically, you should ask about COVID-19-specific changes to the company's cleaning practices, which a representative or the company website should be able to explain in detail. Outwardly visible signs that they went above and beyond a typical cleaning, like hand sanitizer or wipes in cars, are a good sign.

If you're renting a car or a boat, you may choose to wipe the surfaces down yourself, too. As for airing out a rental car for 30 minutes before getting into it, "that's probably overkill," Caravanos said.

You should similarly research rental companies if you plan to rent a boat, according to U.S. Coast Guard Capt. Adam Chamie, a commanding officer in Key West, Florida.

"I would do your due diligence in renting a boat, the same way you would with a hotel room," he explained.

In any situation, think about whether you'll be able to socially distance with ease. A sunset catamaran sail with 100 people? Not a good idea. A fishing charter with family members, on the other hand, may be able to be done safely. Be careful not to crowd spaces where boaters may gather, like marinas, and wear your face mask if you'll be within 6 feet of others.

He also warned against tying boats together to socialize.

"Would you raft-up your table together in restaurant with 10 other strangers?" Chamie asked. "The virus can be spread on the water between boaters who know each other, just like it can at a restaurant or grocery story, or on the streets of Brooklyn, " he said.

"It does't go away just because we’re on the water or on vacation.”

When looking for a rest stop:

Rest stops are high-risk areas, according to Caravanos. Like airports, they may include crowds of people traveling from different areas.

When looking for a rest stop, large open bathrooms with plenty of airflow may be a better option than an often-used gas station with a single toilet, Caravanos explained.

As always maintain social distancing, wear a face mask and practice proper handwashing. "That triad is a requirement," he added.

If you're flying:

If you choose to fly, both Caravanos and Allen said your exposure risk is greater at the airport and during transit to the airport than on the plane itself.

Wash your hands often during your trip, keep 6 feet from others at the airport, if possible, and wipe down your seat and tray. Wear a mask the whole time. Masks generally help to protect others from you, but N95 masks, if worn properly, can help protect you as well.

Traveling from an outbreak hotspot to a place with few infections:

If the virus is spreading in your community, "be mindful that you might be a carrier," warned Allen. If you're traveling from a COVID-19 hotspot, like New York City or Chicago, you could unknowingly spread the virus to an area that doesn't have a large outbreak yet.

Heed the guidance state and local health departments are putting out for visitors from other states. In Massachusetts, for example, people traveling from out of state are "instructed" to quarantine for 14 days. A Vermont mandate requires that out-of-stater travelers quarantine for 14 days upon arrival and should not go out for groceries, walks, hikes or bike rides.

"People have to abide by these rules themselves," Allen said. "It’s a social trust moment.”

If you or a loved one is in a high-risk category:

Everything changes if you, or a family member or partner you'd normally travel with, is in a high-risk category for contracting a severe case of COVID-19. For individuals with underlying conditions, especially older Americans, COVID-19 can be especially deadly.

"I don't think the risk is very high, but the consequences are high. I’m not sure this is the time for family reunion in Vermont with a lot of people," Caravanos said.

For older individuals and high-risk groups, he added, "I would say, sit it out."

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) -- As many as 20 states across the country are reporting a rapid decrease in the number of children receiving their routine vaccinations over the past few months, according to a nationwide survey conducted by ABC News.

The sudden decline comes as many Americans are fearful to visit their doctors' offices for routine check-ups amid the ongoing coronavirus pandemic.

ABC News reached out to health officials in all 50 states, and every one of the 20 states that responded and said they had relevant data available, from California to North Carolina, said they were seeing at least some sort of decrease in vaccination rates and vaccine orders -- including some with drastic, worrying slumps.

It isn’t only health officials that are concerned. As parents worry for their children's safety, physicians say the lack of vaccinations could lead to a resurgence in usually preventable or managed conditions like mumps or the seasonal flu when the nation is already struggling with a deadly pandemic.

Dr. Sara Goza, president of the American Academy of Pediatrics and a private practice pediatrician in Georgia, told ABC News, “My own volumes had been down 40% and on average 40 to 50% in other parts of the nation.”

“Our greatest fear is to have a vaccine preventable outbreak. That would be devastating to families and our nation. We are making a big effort to tell patients we are open and safe but have a long way to go," she said.

Joan Alker, the executive director of Georgetown University’s Center for Children and Families, warned the drop in vaccinations might lead to "mini epidemics" of other childhood diseases, such as measles.

"And this fall, it will be critical to ensure that kids and adults get flu shots when another wave of COVID is expected," Alker added.

The American Academy of Pediatrics this week launched a digital marketing campaign, “Call Your Pediatrician,” to urge parents to get caught up on their vaccines.

"The parents are really scared in many ways," said Dr. Francis DeVito, a pediatrician in Brooklyn, New York, who said he has seen a 75% decrease in the number of in-office patients seen.

"Even for well care visits, when they do show up, there is a reluctance by the parents to vaccinate because they worry if there is a reaction 'what do we do?'” Dr. DeVito said. “They fear what if I have to go to a hospital, an emergency room. It's our job to reassure them there is no difference than before, and these current vaccines are less reactogenic then those of decades in the past.”

In New York City, there’s been a 42% drop in the number of vaccinations administered for children two years old and younger, according to Mayor Bill de Blasio, and a shocking 91% drop in vaccination rates for children over the age of two.

“I'll give you a comparison. The same six-week period of time last year, 2019, almost 400,000 [vaccine] doses were administered in this city,” de Blasio said on Wednesday. “In the six-week period this year, fewer than 150,000. So, something has to be done immediately to address this.”

De Blasio also emphasized that the drop in vaccination rates is especially dangerous this year. Non-vaccinated children are at greater risk of contracting respiratory illnesses such as pneumonia, and are therefore more “vulnerable” both to COVID-19 and MIS-C, the rare new inflammatory illness in children.

Dr. Richard Besser, the former acting director of the Centers for Disease Control and Prevention (CDC), said “there is nothing that we do for children that has more proven health value than getting them fully vaccinated on time.”

“While we are all hoping for the development of a safe and effective vaccine against the new coronavirus, we can’t let our guard down against the diseases for which we currently have vaccines. Measles, whooping cough, and polio are just a few diseases that we rarely see because of the miracle of vaccination,” said Besser, who was formerly ABC News' Chief Health and Medical Editor.

But multiple states are experiencing the same downward trend in the exact time that experts say vaccines are more important than ever.

Pennsylvania has seen a 76% decrease in vaccinations in children ages four to six compared with the previous four-year average, according to Nate Wardle, a spokesperson for the Pennsylvania Department of Health. Vaccinations in children ages 11-18 are down 72%. And Delaware has seen a 52% drop in child vaccinations administered in April 2020 compared to April 2019, Mat Marshall, a spokesperson for the Delaware Department of Justice, told ABC News.

Maryland, California, Idaho, Arkansas, Connecticut and North Carolina have all reported significant decreases during the same time period. The number of doses in Maryland has decreased by 56%; in California, the number of shots given to children up to 18 years of age has plummeted by more than 40%.

“We are very concerned about the significant drop in immunization rates, particularly for children,” said Kelly Haight, a spokesperson for the North Carolina Department of Health and Human Services, where HPV vaccinations, which prevent cervical cancer and are recommended by the CDC for children aged 11 and 12, in the state are down 72% compared to last year.

Officials in Oregon reported they saw a drop in immunizations for all age groups initially with the pandemic, “but a quick recovery for infant immunization.” However, vaccination rates for older kids, teens and adults has been “slow to recover, if at all.”

“HPV immunization rates have tanked, and show little improvement,” Jonathan Modie, a spokesperson for the Oregon Health Authority, told ABC News. “We also preliminary indications that maternal immunization rates for Tdap, intended to protect newborns against pertussis, may also have nose-dived with a slow recovery."

Florida Gov. Ron DeSantis expressed concern over parents not keeping their children’s immunizations up to date and said the state is also experiencing a decline.

“The surgeon general of Florida is a pediatrician, it’s something he will bring to my attention often because we have seen measles outbreaks in different parts of the country just before all this started and so if you’re not keeping up on that, that’s a problem,” DeSantis said last week.

Some parents, though, said they are torn.

“The first time we went I think it was still too early to really be apprehensive. The second time I was definitely more cognizant of the situation, but went in with a mask on. They had plastic barriers up around the reception area,” said Jessica Weisensell, a first-time mom from Cuyahoga Falls, Ohio, who said her pediatrician’s office was taking temperatures upon arrival and instead of a long wait they were quickly seen. “They were definitely doing everything they could to put everyone at ease.”

Others are saying they are going to wait.

“I don't think there could possibly be a place more germy, despite their best efforts, than a pediatrician's office,” said Kathleen Shortis, a mother of five from Long Island, New York, who canceled the last round of visits and vaccinations for her children.

“The kids aren't going anywhere, school is canceled for the year, there will be plenty of time to catch up when the kids are allowed out and about before they're in large groups again,” Shortis said.

DeVito told ABC News he worries most about the fall as parents become concerned about the upcoming flu season and the demand for vaccines increases.

"In the fall with flu season there is going to be a huge demand and it's actually really unfair to parents and their pediatricians to try and satisfy the necessary requirements for vaccinations in a very condensed time-frame because when people will feel safe to go out and then oh wait school is starting in two weeks. Another panic could ensue,” he said.

Leaders are starting to try and change the trend. Six major hospitals in Los Angeles announced on Thursday they are working on a public outreach campaign to encourage people to go to the doctor, especially to get childhood vaccinations. In New York City, Mayor de Blasio also announced the city would be offering free vaccinations at over 1,000 locations.

The CDC guidance says it is critical for parents to maintain vaccinations as the coronavirus pandemic continues because as states across the country begin to reopen, children may be more at risk without the proper vaccinations.

“As social distancing requirements are relaxed, children who are not protected by vaccines will be more vulnerable to diseases such as measles," the CDC says.

Yet for those who fear going to a doctor’s office right now, some experts say there are creative solutions.

Dr. Julia Skapik, medical director for the National Association of Community Health Centers, says their members in underserved communities are getting creative to meet patients where they are to deliver vaccinations, including empty parking lots.

“I think the public is not fully aware there are preventive services that are recommended for children during this time and how to do it safely," she told ABC News.

"Every pharmacy provides access to vaccines, and those should be utilized to create convenience and limit exposure for children as opposed to a clinical setting," said Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor who also helps run The website provides individuals with information about the locations of vaccines based on their needs.

Copyright © 2020, ABC Audio. All rights reserved.


Ivanko_Brnjakovic/iStockBy BECKY WORLEY and SARAH MESSER, ABC News

(NEW YORK) -- For many, summer is usually spent among friends and family at barbecues or bon fires. And for kids out of school, it usually means daytime play dates with pals.

However, with the coronavirus pandemic, summer looks a bit different this year, and has forced many families to change their plans.

But one virus researcher who lives in a state that’s already opened up may give us a clue as to what the next phases of socializing may look like.

"I'm an extrovert," said Dr. Colleen Kraft, who is an infectious disease physician and microbiologist at Emory University Hospital in Atlanta and a mother of three in Georgia. She said that she understands the need for in-person socializing, especially for kids, and added, "I think it's really important but everybody is weathering this storm differently."

Kraft was a doctor in the front lines during the fight against Ebola and now she's doing the same during the coronavirus pandemic. She has seen how coronavirus has ravaged communities, but she also knows that people need people.

"I think some of the scenes I've seen on television of bars and very busy restaurants makes me anxious," she said. "I get to be witness to people being very sick from this virus and it's serious."

Since the pandemic began, she's taken extra precautions to keep her family safe and has also leaned on a limited number of close friends she's called her "Quaranteam" or "Coronavirus Circle," made up of people who are healthy and who are taking similar safety measures that she and her family sees in person while practicing social distancing.

"Who you feel comfortable having your family and children around because they share the same prevention tactics," Kraft described.

While Kraft socializes outside at a distance with her quaranteam, she is more conservative in other activities. She told ABC News she isn’t yet comfortable going to the gym, the mall, getting her nails done or letting children play at the park. She also keeps trips outside the house to a minimum, including trips to places like the grocery store, and she wears a mask.

"We have a very small circle of people we interact with," she said, explaining that this allows her kids to have play dates and lets the kids play games that don’t have physical contact.

For the adults in her group, she hosts "the six-foot hang out," which separates everyone into groups, all six feet apart, allowing them to spend time together without masks.

"Even when interacting with them, we don't spend a lot of time you know, and it's always outside," she said.

Experts advise no one in the group should have underlying medical conditions and it’s important to note that in many states these gatherings are still not allowed, and even in Georgia groups of 10 or more are not permitted to gather unless they can social distance. The Centers for Disease Control and Prevention also advises against it.

While Kraft does still have small gatherings with her coronavirus circle friends, she assured that they all do everything they can to stay safe, and don't even share food or utensils.

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) -- A number of commercially available COVID-19 antibody tests, which look at a patient’s blood for signs of past infection, did not pass Mayo Clinic quality screening or meet their expectations for use, researchers from the hospital concluded in a joint investigation by the clinic and ABC News.

One rapid finger-prick test even wrongly displayed a positive result for antibodies after researchers decided to use a saline-like solution, instead of a blood sample, to see what happened. An automatic fail, doctors said.

“Clearly there had been a mistake in how that kit was constructed,” said Dr. Thomas Grys, the director of microbiology at Mayo Clinic who tested the rapid test kits, which typically rely on a finger prick and a drop of blood to return results in 15 minutes.

Grys said the Mayo Clinic alerted the manufacturer of the test kit of the problem and by Thursday, they had a "reformulated" version that appeared to correct the mistake with the saline-like solution. The researchers are still testing the kits' overall accuracy.

In partnership with the ABC News Investigative Unit, Mayo Clinic doctors in Arizona and Minnesota ran over 4,500 tests on both rapid and slower, traditional lab antibody tests. Nineteen different COVID-19 antibody brands selected by the clinic were tested in under a month, a process that would normally take around a year, they said. For the review, the clinic did not provide brand names to ABC News.

“We evaluate tests and make sure they perform well before we offer them to our clinical colleagues and to providers to use,” said Dr. Elitza Theel, an associate professor of laboratory medicine and pathology at Mayo Clinic and the researcher who put the laboratory test kits to a test themselves. “And so this really underscores why laboratories continue to evaluate and validate tests thoroughly before offering them for clinical care."

Of the 19, nine were rapid antibody tests designed to give a result in just minutes. But four out of nine of those rapid antibody tests examined failed the Mayo Clinic’s testing process for various reasons, including low accuracy and physical problems with the actual tests. Quality issues like these, the team said, are why the Mayo Clinic has not yet made a decision about using finger-prick blood tests to look for antibodies in its own clinical patients.

“Our job is every day to make sure that we’re giving the right answer on every specimen from every patient,” Grys said.

The Mayo Clinic team also saw performance issues with more sophisticated laboratory blood analysis in which a larger sample of the patient’s blood is drawn and taken away to be tested in a lab. They found these laboratory tests fared slightly better but still had problems.

“Out of the 10 test kits that we looked at, there were four that really had A plus ratings, there were a couple that were in the B ranges, and there were two or three that were in the F range that we definitely wouldn’t want to use in a clinical laboratory,” said Theel.

Theel said four of the kits tested had been given emergency use authorization by the Food and Drug Administration -- each of which received A plus ratings in the Mayo Clinic review. The other tests are either under evaluation or had not applied for the authorization.

Theel’s team found that one laboratory test came back with a false positive rate of 17% -- meaning that 17 out of 100 people tested, who were never infected, would be falsely told they had antibodies.

“If a kit has a false positive, the concern is we think they have antibodies against the coronavirus, but really they don’t,” Grys said. “So then that person might be at risk because they think they don’t maybe need to wear a mask, or they can care for someone who’s sick with the coronavirus, and they would be exposed and not protected.”

Experts say a key metric for testing is something epidemiologists called "specificity" -- meaning how well a test identifies who does not have the novel coronavirus. While Theel said that no test is perfect, she said her team looks for tests with a specificity in the upper 90 percentile.

Calls for increased testing and companies pressured to make up lost time because of testing delays may have created a perfect storm for poorly functioning tests, the research team said.

“There’s a real pressure on manufacturers to bring these to market as quickly as they can, which means they don’t have the same opportunity to vet these things in their own manufacturing processes before they bring them out and make them available to the public,” Dr. William Morice, professor of laboratory medicine and pathology at Mayo Clinic, told ABC News. “And they’re a business. You have to look at this as a business, and there’s a business pressure to get these tests out as quickly as possible.”

With increasing consumer curiosity regarding antibody testing, the Mayo Clinic team is feeling the pressure to offer doctors, laboratories and patients more reliable information.

“We need to find out which [tests] are good,” Grys said.

From a consumer perspective, the problem is that the process for determining which tests can be trusted isn’t simple.

In March, the Food and Drug Administration created a path for rapid approval of coronavirus antibody tests called an emergency use authorization (EUA) and also permitted tests to come to market without manufacturers seeking such approval.

There are currently only 12 antibody tests in the U.S. that have received FDA EUA status, including the four that received the A plus rating in the Mayo Clinic review. But, as of Wednesday, there were over 200 antibody tests available on the market that had either not sought or received such authorization.

The FDA maintains a public website with the performance rates of the 12 EUA tests, showing how likely a certain test is to give false positive confirmations of the antibodies, and sensitivity, how likely the test will give a true positive result when someone has the virus. But the numbers can be hard to interpret by consumers who don’t have medical backgrounds.

So what should a consumer do if they’re interested in having an antibody test done? The Mayo Clinic team recommends patients work with a trusted medical provider instead of pursuing an antibody test on their own, and to ask that doctor if the antibody test being used is one of the 12 tests currently given the FDA's EUA.

“I would just ask the doctor if they can confidently say yes they had COVID-19 if the test is positive, or no they didn’t if the test is negative,” Morice said. “If [the doctor] can’t say that with confidence, then I would be a little concerned about the test they’re using.”

For Kelly Wrobleski, the director of infectious disease at the Association of Public Health Laboratories, the risk of inaccurate antibody test results outweighs the potential rewards.

“I think there's too many poor-performing tests on the market, and I don't think they give you really good information on how you should or shouldn't change your behavior,” Wrobleski said.

Initially, the FDA did not object to antibody tests being used even without an emergency use authorization. But with growing concern of antibody test reliability, two weeks ago, the FDA updated its antibody testing policy saying manufacturers would have to submit an EUA or go through validation at the National Cancer Institute if they wanted to sell an antibody test and were given 10 business days to do so.

“This is a top priority for the agency," an FDA spokesperson told ABC News Wednesday.

In the coming days, the FDA says it will separate out tests that have not been through an EUA or other valid approval process.

“I hope they start to pull those from the market and start to hold those manufacturers accountable to not selling them,” Wrobleski said. “My hope is that by June we start to see only tests that have shown some level of quality performance out there.”

Late Thursday, the FDA announced it is posting online the names of antibody tests that it said have been removed from the "notification list" of tests being offered under the department's emergency coronavirus policy, including those that were voluntarily withdrawn and those for which there is no pending EUA request or authorization. The FDA said it expects the tests that are removed from the list will "not be marketed or distributed."

FDA Commissioner Stephen Hahn called the move an "important step the agency has taken to ensure that Americans have access to trustworthy tests."

As of Wednesday night, there are more than 1.5 million diagnosed cases of COVID-19 in the U.S., with at least 93,439 deaths reported, according to data provided by Johns Hopkins University.

Copyright © 2020, ABC Audio. All rights reserved.


Prostock-Studio/iStockBy ABBY CRUZ

(NEW YORK) -- With mental health resources in high demand during the coronavirus pandemic, one doctor has stepped up to give tips online and through her book to help others cope.

Dr. Rheeda Walker created a guide for people of color who cannot afford or do not have access to mental health help called The Unapologetic Guide to Black Mental Health: Navigate an Unequal System, Learn Tools for Emotional Wellness, and Get the Help You Deserve.

The book has seen a spike in demand due to COVID-19 and has been called a saving grace by the likes of hip-hop radio personality Charlamagne tha God, who is outspoken on mental health in the black community.

"I wrote The Unapologetic Guide to Black Mental Health because I wanted to shift the conversation about mental health and the African American community and how we talk about it because there's so much stigma," said Walker. "There's so much resistance to the conversation that I felt like we just needed to turn that shift completely around."

Walker has also found a way to meet the demand for people who do not have access to her book: Instagram. Walker uses the app as a way to interact with people who seek help, goes live to take part in Q&As, and posts ways to cope while at home. She also started a YouTube account to help those who do not have Instagram.

"This is a really tough time across communities because we're going through this pandemic that nothing and absolutely nothing could have prepared us for," said Walker.

Because of that, she said, she encourages people to "cut ourselves a little bit of slack and provide a little bit of grace and recognizing that this is a tough time."

"We're not expected to be able to function at the level that we were pre-pandemic, it's just it's simply not an option," she said.

Walker says the inspiration behind her book title is the stereotypes that come with seeking help for mental health. She explains that oftentimes, people in the black community do not have the courage to seek mental health help because they are afraid of being called "crazy" or being judged by their peers or they ignore signs they need help.

"I don't think that we realize the degree to which mental challenges aren't about hearing voices or being disconnected from reality," said Walker. "We all need to be able to do a little bit better so that we can function at work, function at school, be in relationships and pursue our life goals."

Walker says her book can be a tool for all people of color in need of mental health support, even for those who may believe that "all you have to do is pray about it" to deal with challenges they may be facing. Walker agrees with that theory to a certain extent, giving religious insights and even Bible scriptures in her book, but wants her readers and others to know that sometimes you need other avenues of help.

"Praying is great, but by all means, if you feel like you need help, please do more than pray," she said. "I challenged some of these cultural narratives. But I also want to make sure that we shine a light and pay attention to some of the things that are happening [in the African American community]."

Walker explains that there are several different ways to cope with mental health right now, depending on the situation. For people who have anxiety during this time, she recommends getting more rest, taking time to sit down to drink some tea and taking some moments to regroup. She also recommends reaching out to family members and friends.

But her key tip is to be a good listener.

"If someone reaches out to you, be a good listener, we don't have to solve problems. Just listen," she said. "Because we have to be here for one another. We have to be here for ourselves. And we have to create a community where we're here. We're here for one another as non-judgmental listeners."

Copyright © 2020, ABC Audio. All rights reserved.


oonal/iStockBy BEN GITTLESON, ABC News

(NEW YORK) -- After researchers at Columbia University this week estimated about 36,000 lives in the United States could have been saved from the novel coronavirus had social distancing and other restrictions been put in place a week earlier in March, the White House on Thursday pointed a finger at China.

“What would have saved lives is if China had been transparent and the World Health Organization had fulfilled its mission,” White House deputy press secretary Judd Deere said in a statement. He echoed President Donald Trump's frequent accusations China and the W.H.O. failed to adequately inform the world about the burgeoning outbreak of COVID-19 in China's Wuhan province.

Disease modelers at Columbia University said in a study released Wednesday that 61.6% of deaths and 55% of infections nationwide could have been avoided if preventative measures in place on March 15 had been enacted a week earlier. That equates to about 35,927 deaths and 703,975 cases.

Asked about the study on Thursday, President Donald Trump said "Columbia's an institution that's very liberal," and without providing any evidence, added, "I think it's just a political hit job."

"I was so early," he told reporters outside the White House, defending his administration's response to the virus. "I was earlier than anybody thought."

The study has not yet undergone the typical scientific peer review process, and all models are merely estimates, subject to change with new information.

Nevertheless, the Columbia researchers determined that if the measures had begun two weeks earlier, then 82.7% of deaths and 84% of infections -- or about 53,990 deaths and 960,937 cases -- could have been prevented nationwide, they found.

Trump has faced widespread criticism for his administration's slow response to the pandemic, with the president downplaying the threat even as deaths and infections shot up across the country. In turn, the president has frequently accused China and the W.H.O. failed to adequately inform the world about the burgeoning outbreak of COVID-19 in China's Wuhan province.

“What would have saved lives is if China had been transparent and the World Health Organization had fulfilled its mission,” White House deputy press secretary Judd Deere said in a statement earlier Thursday.

Trump has often cited his decision in late January to block most travelers who had recently spent time in China from entering the United States, although his administration did not enact similar restrictions on travel from Europe until March 14, or recommend widespread social distancing in the United States until March 16.

In an interview with Fox Business Network Thursday morning, Vice President Mike Pence pointed to the United States' restrictions on travelers coming from China and Europe, although he stopped short of pointing a finger at China or the W.H.O. He noted the White House launched a task force to deal with the virus, too.

"We bought an extraordinarily important amount of time so that in early March we actually had only some 14 cases of domestic transmission of -- of actual spread in the United States," Pence said.

But subsequent research has shown that COVID-19 was likely far more widespread in the United States in early March -- and before -- than that low case count revealed.

“What did save American lives is the bold leadership of President Trump, including the early travel restrictions when we had no idea the true level of asymptotic spread," Deere, the White House spokesman, said. He pointed to the private sector's work on delivering "critical supplies to states in need and ramp up testing across the country that has placed us on a responsible path to reopen our country.”

While the federal government was slow to recommend social distancing measures, it was governors and local officials who called the shots and who, in many cases, acted more quickly.

A White House official said the “success” of responding to COVID-19 “has been built on the federal-state partnership, not a federal government coming in and telling governors and mayors what decisions to make for their communities when a bureaucrat in Washington has [no] idea what is best for them.”

While Trump has repeatedly said he prefers governors take the lead on testing and rolling back restrictions, he has also frequently attacked Democratic state leaders -- often in political battleground states key to his reelection later this year -- for moving too slowly.

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) -- Nursing homes serving mostly minority populations are twice as likely to experience a deadly coronavirus outbreak as those with mostly white residents, according to new research on the devastating impact the highly contagious illness is having on vulnerable residential care facilities.

“Our biggest predictor was race,” said R. Tamara Konetzka, a professor at the University of Chicago who led the study. “The higher percent white residents in a facility, the less likely that facility has had a single case or a single death.”

The disparity in deaths in nursing homes mirrors a larger national trend that is seeing minorities disproportionately impacted by the virus. Black Americans and Latinos make up about a quarter of the nation’s nursing home population, according to the Centers for Disease Control and Prevention.

The research shows that nursing homes serving mainly minority populations experience at least one case of coronavirus at higher rates than facilities serving majority white populations, according to Konetzka. The same is true when considering the rate of death from the virus. And while the virus has proven to have a devastating impact on all nursing homes, the data shows facilities with large minority populations are being impacted at a higher rate.

Konetzka told ABC News some of the same disparities that have made those minority communities more vulnerable to the virus are even more acute in nursing homes, where non-white residents more regularly rely on Medicaid to pay for their care. Medicaid is a federal program that helps provide health coverage for low-income families.

This report is part of “Pandemic – A Nation Divided,” ABC News' special coverage of the heightened racial/ethnic and socioeconomic disparities amid the COVID-19 pandemic. Tune into "Nightline" at 12 a.m. ET Thursday on ABC for the second part of the three-day series.

Konetzka's study, by her and fellow University of Chicago colleague Rebecca Gorges, has not yet been published, but she said she plans to present the findings before lawmakers Thursday. The research draws from public data from 12 states, covering 5,527 nursing homes, about a third of which had at least one case of COVID-19.

Konetzka said Medicaid-funded facilities are often cited for having a lower quality of care and fewer staff to care for residents -- some of the same factors that federal officials who regulate nursing homes are seeing in homes with the most deadly COVID-19 outbreaks.

Seema Verma, who runs the Center for Medicare and Medicaid Services, told ABC News last week that the agency was seeing more fatalities in facilities that did not have appropriate staffing in place. She cited the agency’s review of a Seattle nursing home where coronavirus killed 37 people in March.

“There was not a physician that was available,” Verma said. “So as patients were having problems, as they were deteriorating, they didn’t have the appropriate backup in place.”

The new research on racial disparities in nursing home outbreaks comes as Congress is focusing fresh attention on the array of factors that have made nursing homes one of the deadliest settings during the coronavirus outbreak.

More than 26,000 deaths from the disease have occurred in nursing homes, and the densely-populated facilities have accounted in some states for more than half of all fatalities, according to an ABC News survey of 38 states plus the District of Columbia. Not all states yet report this data, and the federal government does not have a public national tally.

Konetzka is scheduled to share her findings Thursday with the Senate Aging committee during a hearing on the impact of coronavirus on aging populations. The hearing will be the Senate’s first to focus explicitly on the needs of seniors since the virus took hold in March.

Sen. Susan Collins, R-Maine, who chairs the committee told ABC News she is “focused on helping to protect the health of vulnerable seniors in long-term care facilities during this pandemic.”

One major focus for nursing home providers is money. The industry has asked for $10 billion to help nursing homes survive financially as the crisis has gripped them.

Congress has already provided some aid to nursing homes as part of the $2 trillion coronavirus relief package passed in March, including $200 million allocated to the Centers for Medicare and Medicaid to assist the agency with infection prevention in the homes.

The stimulus also allocated $100 billion to provide assistance to health care facilities, for which nursing homes are eligible alongside hospitals and other facilities. The Department of Health and Human Services is responsible for distributing these funds.

A group of House Democrats recently wrote to HHS Secretary Alex Azar contending that not enough of the aid money has gone to nursing homes.

“Long-term care facilities are struggling to contain these outbreaks and keep their residents and workers safe,” the letter from 19 members said. “Additional financial resources would allow facilities to purchase more personal protective equipment and cleaning supplies, add additional staffers, and improve access to testing for residents and workers -- which is the foundation of any containment strategy.”

Senate Democrats have also highlighted new data published by the Government Accountability Office, which found that even before the pandemic, many nursing homes failed to meet federal standards on a variety of infection prevention and control measures.

"For years nursing home surveys pointed out areas where federal standards for nursing home safety and enforcement efforts should be improved, but the Trump administration chose not to correct them," Sen. Ron Wyden, D-Ore., said. "Too many seniors and their families have suffered as a result of this pandemic, and there need to be big changes in the way nursing homes care for seniors.”

The federal government has taken steps in recent weeks to provide other forms of direct aid to nursing homes. The Federal Emergency Management Agency began large shipments of masks, gowns and other protective equipment that are eventually supposed to reach all facilities nationwide. Last week, Vice President Mike Pence announced that the federal government wants nursing facilities to test all patients and staff over the next two weeks.

Thursday’s hearing will mark the Senate’s first steps toward charting new legislation to help with the ongoing nursing home crisis.

One topic expected on the agenda is how to handle an expected flood of lawsuits against homes where residents died during the outbreak. Several of the nursing homes involved in early outbreaks have already been informed of impending legal action.

Alexander Clem, an attorney with the Florida firm Morgan & Morgan that has announced its intent to sue a nursing home where 16 residents died, said the ability to hold facilities accountable is essential to ensuring patient safety.

“When nursing homes choose to not inform families, when they don’t get their staff tested or give their employees [protective gear], and when they don’t follow infection [protocols], that is when these outbreaks start spreading like wildfire,” Clem said during a press conference last week. “I foresee this being a nationwide endeavor for us across all 50 states. If there's a cluster and if they negligently are handled or grossly negligent to one of our loved ones, we'll be holding them accountable.”

Senate Majority Leader Mitch McConnell has repeatedly stated that he considers such lawsuits to be “frivolous,” and that one of his top priorities will be to enact liability protections for business and medical providers involved in caring for patients during the COVID-19 outbreak. McConnell has said the new protections would not provide total immunity.

"There will be accountability for actual gross negligence and intentional misconduct," McConnell said earlier this month. “We aren’t going to provide immunity. But we are going to provide some certainty."

McConnell has suggested he will reject any additional coronavirus relief legislation that does not include liability protection for health care providers. That has put him at odds with one of the nation’s largest organizations advocating on behalf of older Americans -- the AARP.

“With the limited accountability we have right now because of the lack of family visits, having this basic legal accountability is one of the few things that we have left to make sure that they keep peoples loved ones safe,” said David Certner the Legislative Counsel and Legislative Policy Director for Government Affairs at AARP. “The point is to maintain accountability especially at a time when there is none."

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) -- The old saying goes: "There's strength in numbers." And now, it turns out numbers may be the greatest defense against the spread of COVID-19.

It's a concept called herd immunity: Once enough people become immune to the novel coronavirus, it can't spread easily throughout the population.

 Vaccinations are necessary to create that kind of large-scale immunity, as the virus won't just disappear without a vaccine, according to Dr. Anthony Fauci.

"That is just not going to happen, because it's such a highly transmissible virus," Fauci said in his address to a Senate panel last Tuesday. "Even if we get better control over the summer months, it is likely that there will be virus somewhere on this planet that will eventually get back to us."

Herd immunity doesn't mean there won't be any virus transmission, but it does mean that people with immunity function as kinds of roadblocks to stop rapid contagion.

Could the United States reach a point where the novel coronavirus cannot easily spread? As public health officials battle an ever-expanding crisis, epidemiologists suggest there is still a long way to go before reaching herd immunity for COVID-19.

Thanks to vaccinations, herd immunity has been effective at eliminating polio, smallpox and, until recently, measles.

It's something we'd like to see with COVID-19, sooner rather than later, but how do we get there?

The threshold for achieving herd immunity -- the fraction of the population that needs to be immune to a disease to make person-to-person transmission extremely unlikely or even impossible -- varies from virus to virus. With measles, for example, that threshold is high: 93% to 95%.

Some have argued it could happen naturally as the virus makes its way through our communities, but without a vaccine to supercharge immunization, infectious disease experts point out that any pursuit of herd immunity through natural infection could come at a tremendous cost. Allowing many people to get sick quickly could cause a spike in infections that could place enormous stress on the healthcare system, and many people would die.

Hopefully, a vaccine for COVID-19 will be available within one to two years, according to Fauci.

"It's definitely not a long shot," Fauci said at last week's Senate hearing. "It's clearly much more likely than not that somewhere in that time frame, we will get a vaccine for the virus."

Many have also been wondering: Do people develop some immune protection after they recover from COVID-19? Experts think that may be the case, but nothing is proven. And even if it is true, no one is sure just how long that immunity may last.

Since achieving herd immunity is the goal, you first need to understand how fast the virus infects other people. That basic reproduction rate is what scientists call the "R nought" of the virus. And for the virus that causes COVID-19, that number is somewhere between two and three. That means each person with the novel coronavirus can infect, on average, two or three others.

You can't change anything about the virus, but people can change things about themselves and their behavior to effectively slow the spread.

When someone becomes immune or stays physically distanced from others, it's harder for the virus to spread, and the average number of people that the virus can infect is lower. That new number, factoring in how susceptible the population is, is called the effective reproductive number.

The goal is to drive that number down. If the effective reproductive number is greater than one, then the virus can still spread rapidly. The closer the effective reproductive number is to zero, the better.

In a world where no one is immune to COVID-19 and everyone is at risk, the virus can spread like wildfire. But in a world where there is herd immunity -- for example, if 75% of people are already immune -- that means three-quarters of people exposed to anyone with the virus just won't get sick. So, even if a few people have the virus, the rest who are immune stop it from spreading.

Epidemiologists use a formula to calculate herd immunity based on the virus's basic reproduction number: (R0 − 1)/R0.

Based on what experts know about the contagiousness of the novel coronavirus, "the critical threshold for achieving that herd protection for COVID-19 is between 50% and 66%," Dr. Justin Lessler, an epidemiologist at Johns Hopkins University told ABC News.

That means that somewhere between 150 million and 216 million Americans need to be immune to meaningfully stop the virus from spreading throughout the country. But right now, most experts say the country is probably a long way away from these kinds of numbers.

The great thing about a vaccine is that it can help build a person's immunity without making him or her sick. So, just like with many other infectious diseases, the show-stopper will be when most people can get a vaccine -- once we have one that's proven to work.

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) -- You may have heard a lot about COVID-19 antibody testing recently. In fact, your doctor may have even offered you the option of getting the test.

Just because you can get an antibody test, should you?

Antibody tests are most useful from a public health perspective to estimate how many people have been previously exposed to the virus, experts say.

But they admit that for individual people hoping to use the tests to make better decisions about their health, antibody results may be less helpful, at least until questions around their accuracy are resolved and scientists learn more about recovered COVID-19 patients.

Nevertheless, major diagnostic laboratory companies have ramped up their performing capacity to offer these tests directly to consumers. Quest diagnostics, one of the major players, has offered 975,000 COVID-19 antibody tests in just over a month, a number that could increase to 1.4 million each week.

Here’s what you should know and consider before getting a COVID-19 antibody test.

What’s an antibody test?

Antibody tests use a blood sample, either through a fingerprick or blood draw, to determine whether or not you were previously infected with the virus that causes COVID-19.

“Antibodies are markers of an infection you had,” Dr. David Grenache, president-elect of American Association for Clinical Chemistry and chief scientific officer of TriCore Reference Laboratories, told ABC News.

What types of antibody tests are available?

Not all antibody tests are created equal. There are two major types of COVID-19 antibody tests available to consumers: rapid antibody tests, which, like a pregnancy test, can give yes or no results within minutes, or a laboratory-based antibody test, which can take a couple of hours to process and provide more information on the level of antibodies present.

Dr. James Baker, who specializes in immunology and diagnostic laboratory tests, says some rapid antibody tests are very good at detecting people with very high levels of antibodies but the “low level positives are hard to read.”

Are all antibody tests on the market reliable?

Unfortunately no. It is your responsibility along with your provider to make sure the test you pay for can be trusted. Before you purchase a test ask your health care provider whether or not the test has been reviewed by the Food and Drug Administration.

Be on the lookout too for any important disclosures. The FDA may have granted emergency use authorization for the test.

Inquire into the sensitivity and specificity of the test. Sensitivity refers to “how often does this test get the correct result in a person that has the antibodies,” said Dr. David Grenache. A test with low sensitivity means that it “has the potential to give false negative results, meaning that the antibodies are actually present, but the test fails to detect it," he noted.

According to Grenache, specificity refers to the tests’ ability to accurately return a negative result.

At the start of the U.S. pandemic, the FDA allowed commercial manufacturers to distribute their own antibody tests as long as they had self validated their own tests and provided evidence to the FDA.

“So many tests of suboptimal quality have flooded the market and that’s been a serious cause for concern,” said Grenache.

The FDA more recently tightened its policies following criticism from medical experts and government officials. Now all commercial manufacturers are required to apply for emergency authorization and provide the FDA with more thorough data about their tests’ performance. The FDA will review this data to decide whether or not the test can remain on the market. The FDA said it will begin reviewing these tests and prioritize those that appear to be of more dubious quality.

The timeline, however, for when this review process will be complete or when the agency will take action against questionable antibody tests is still unclear. For now, only 12 COVID-19 antibody tests have received emergency authorization by the FDA. The FDA publicly shares information about these tests online. Many antibody tests that are not yet FDA reviewed may still be available to consumers.

The FDA warns that even a good test has its limitations. In areas where the rates of infections are very low, the agency says a second antibody test might be necessary to confirm results.

What does an antibody result tell you?

An antibody test cannot diagnose COVID-19 infection on its own. It can only show you whether or not you were infected with the virus in the past.

If you’ve experienced certain symptoms a couple weeks ago and are believe you may have had COVID-19, an antibody test might be useful in determining whether or not you were in fact infected.

Knowing you have antibodies to COVID-19 may also make you an eligible candidate to donate plasma for convalescent plasma therapy, an experimental COVID-19 treatment.

Beyond that, a positive or negative result should not change the way you behave.

“Until we know more, there is not a lot of value to antibody tests right now,” said Grenache.

Scientists are still learning about whether or not antibodies confer any protection or immunity from future reinfection. In fact, the World Health Organization has cautioned against issuing “immunity passports” for people who test positive, saying "at this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity.”

CityMD recently apologized and reversed a previously incorrect statement shared with consumers through its patient portal which said, “Positive result on the COVID-19 antibody test confers immunity.”

Baker warns that testing positive for antibodies does not necessarily confer immunity.

“People need to understand that they may not be totally resistant to reinfection and need to be continue to be careful and distant,” he said.

Timing is important

Antibody tests typically detect one to two different classes of antibodies, which are produced by the body at different times during the course of infection and recovery.

Most of the antibody tests authorized by the FDA only detect IgG antibodies. It is estimated that IgG COVID-19 antibodies typically develop around seven to 10 days after infection. That means if you take an antibody test within a week or two of being infected, the test may deliver a negative result because it couldn't find the tell-tale antibodies in your blood.

“Even a very sensitive IgG test will only result in a positive result late on. It could be a couple weeks and you might still not have antibodies detected. You may have a false negative because it’s too close to when you thought you were infected,” said Baker.

Bottom line: Ultimately it’s your choice whether or not to get an antibody test. Baker says that consumers should keep their providers accountable.

“If they can’t explain what the test means to me in a way I can understand they shouldn't be providing the test," he said.

Eden David, who studied neuroscience at Columbia University and is matriculating to medical school later this year, is a contributor to the ABC News Medical Unit.

Copyright © 2020, ABC Audio. All rights reserved


Oks_Mit/iStockBy IVAN PEREIRA, ABC News

(ATLANTA) -- If you're heading to the pool this summer, you'll have to bring your swim cap, goggles, towel -- and face covering.

The Centers for Disease Control and Prevention released new coronavirus-related guidance for swimmers and employees at the country's pools as they reopen to crowds this summer. Several states have already reopened their public and private pools, including Georgia and Florida, and the agency said pool administrators should stick to several precautions to prevent the spread of the virus.

ABC News

Pool users and staff are encouraged to wear face coverings if they are outside the water. Swimmers are encouraged not to have them on when they are in the water according to the CDC.

"Cloth face coverings can be difficult to breathe through when they're wet," the agency said in its recommendation.

The CDC dissuaded group gatherings in and out of the water, especially if six feet distancing cannot be enforced. The agency recommended staggered pickup and drop-off times if planned events take place, and swimmers stay six feet apart from anyone who they don't live with.

Lifeguards should not enforce social distancing and other COVID precautions, according to the CDC and advised that other staff members serve those roles.

The CDC said that pool staff should do everything they can to ensure pool-goers stick to the health precautions, including more signage, highlighted visual cues on the deck and in the pool, rearranged furniture and frequent announcements. The agency added that it should encourage pool-goers to avoid sharing items, such as toys and towels, and all communal areas should be frequently cleaned.

Copyright © 2020, ABC Audio. All rights reserved.



(NEW YORK) -- “I think I had it.” You’ve likely heard someone say it, or perhaps you’ve been muttering it yourself.

It seems these months of quarantine-life and a growing list of COVID-19 symptoms are leading many to think back to that stubborn cold from back in February or that sudden stomach bug that hit in March and wonder if it really was the coronavirus.

Call it “I-think-I-had-it-itis."

But a hospital study in New York City has found that out of hundreds of New Yorkers who thought they potentially had COVID-19 in the last three months but never received a confirmed clinical diagnosis, only 37% tested positive for COVID-19 antibodies, a sign the body was previously likely infected and fought the virus.

“That does imply that likely many of the people who suspect that they had this probably didn't have it,” said Dr. Ania Wajnberg, one of the authors of the Mount Sinai study and an associate professor of medicine at the Icahn School of Medicine. “You can't assume that you had it just because you didn't feel well a few months ago.”

In comparison, 99% of New Yorkers tested by Mount Sinai who had a confirmed COVID-19 diagnosis did have antibodies, the cornerstone of the body’s immune response to a virus, the researchers reported.

Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor, said he, too, had a bit of "I-think-I-had-it-itis."

"As someone who actually was convinced that they had been infected and then tested negative, it’s clear that many of us have been in the same boat," he said. "What we need to remember is that COVID-19 was circulating at the same time as a number of respiratory viruses likely creating confusion on the origin of infection."

Brownstein said the new data suggests that the U.S. could be "a ways off [from] herd immunity and further demonstrates the need of testing capacity."

The findings were among the first to come out of Mount Sinai’s monumental antibody testing program, which is now performing over 3,000 tests a day, tallying over 25,000 people so far. The study, which was published earlier this month and has not been peer-reviewed, looked at the initial 1,343 people tested in the program, including those who had previously confirmed coronavirus infections and those who suspected, or were told by their doctors, that they likely did but were not tested.

The broader aim of the antibody program is to identify donors for convalescent plasma, an experimental treatment sometimes used for seriously ill hospitalized COVID-19 patients.

“We've given convalescent plasma to hundreds of patients at the Mount Sinai health system, and that's been a good thing to be part of,” Wajnberg said. “And it's also helping us learn about potential immunity.”

Researchers at Mount Sinai were among the first in the U.S. to develop an antibody test and received emergency use authorization (EUA) from the Food and Drug Administration in April. There are currently 13 such tests with EUA in the U.S.

This week, Mount Sinai announced it is beginning to commercially produce its antibody test with a goal of testing more than 10 million patients per month by July.

Antibody tests are distinct from what are called diagnostic coronavirus tests, which look for live virus currently infecting the body. The Mount Sinai study said the results suggest "the optimal time frame for widespread antibody testing is at least three to four weeks after symptom onset and at least two weeks after symptom resolution."

Antibody tests not only allow doctors to understand who has antibodies, but can also help reveal how strongly a person responded to the virus. And, depending on the kind of antibody found, these tests can signal whether or not a person may have some immune protection to future infection.

The kind of antibodies that experts are hoping to find are called neutralizing antibodies – those that have the power to squash the coronavirus. But because the current coronavirus circulating is new, scientists can’t yet say with certainty that having antibodies means someone is immune to re-infection.

“We are hopeful that like most respiratory viruses, the presence of antibodies in your system is going to be protective for some time,” Wajnberg added. “However, since we haven't had a lot of time to actually monitor this and do the testing that we've done for other viruses, we don't know for sure yet. So there's still work that needs to be done before people with antibodies can sort of run back into the world and assume that they're going to be fine.”

Copyright © 2020, ABC Audio. All rights reserved.



(WASHINGTON) -- The Federal Trade Commission and Justice Department are seeing a rising number of promotions of allegedly bogus treatments and cures for COVID-19, which they charge are in certain cases pushed directly by doctors and other licensed health care professionals.

The FTC and Food and Drug Administration this month sent a new batch of warning letters to companies and individuals it accused of making "unsubstantiated" claims about products and therapies to treat the coronavirus.

"There are no FDA-approved cures, tests, prevention mechanisms, vaccines," FTC Commissioner Noah Phillips said in an interview with ABC News. "If someone is telling you that's what they're selling you, it's not true."

According to a statement, the commission's latest batch included 45 letters -- bringing the total warnings issued since the start of the crisis to nearly 100. As of Tuesday, FTC data showed the commission has so far received more than 49,000 overall complaints related to COVID-19, that includes more than 28,000 fraud complaints. Of those 28,000 complaints, the commission estimates consumers have suffered more than $35 million in losses since the start of the pandemic.

"People are spending hard-earned money, maybe they don't even have a job and they're spending money," Phillips said.

In certain instances in recent weeks, federal prosecutors have moved to shut down and even prosecute individuals accused of promoting products or therapies.

After a request from the U.S. Attorney's Office for the Northern District of Texas, a federal judge ordered a Dallas-based chiropractor, Dr. Ray Nannis, to halt any further promotion of COVID-19 treatments after he posted videos advertising a "homeopathic" therapy for customers.

"It can help the body up to 90%," Dr. Nannis said in one video. "It gives the body an immunological and a neurological recognition of the energy of the frequency of a virus in this specific one being the coronavirus."

In a press release announcing the injunction against Nannis, the U.S. Attorney’s office accused him of "preying on customers' basic human condition, fear."

Nannis agreed to stop making such claims following the judge's order, and had no further comment on the allegations when asked by ABC News.

In Michigan, prosecutors have charged Dr. Charles Mok with health care fraud after he allegedly sold patients a Vitamin C IV therapy that they say he claimed could protect the body from the coronavirus. A criminal complaint also accused Mok of endangering workers and customers after several employees who had reportedly tested positive with COVID-19 continued to work in the facility.

Mok's attorney declined to comment when reached by ABC News, instead saying, "we believe the appropriate forum is the courtroom." Mok has not yet entered a plea in the case.

San Diego Dr. Jennings Staley was also charged with mail fraud last month after allegedly offering a nearly $4,000 "family package" to treat COVID-19 that included access to telemedicine, hydroxychloroquine, Xanax and even Viagra.

A lawyer for Dr. Staley, who has not yet entered a plea in the case, told ABC News he doesn't believe the government has proven any kind of fraud.

"(Dr. Staley) presented pros and cons of this medication, he believes in this medication," attorney Patrick Griffin said. "He had no intent to defraud. He genuinely believed that what he was doing was in the best interests of his patients."

Though federal officials have expressed alarm about licensed health care professionals allegedly taking advantage of the current crisis to dupe patients, the cases represent an otherwise isolated sample among the vast majority of health care professionals offering sound advice during the public health emergency.

"If people want good health information, they should consult with their doctor or go to a government Web site like or our website like to find out important information," Phillips said.

The DOJ has urged Americans who believe they are a victim of fraud or an attempted COVID-19 scam to alert law enforcement by calling the National Center for Disaster Fraud Hotline at 1-866-720-5721 or by emailing

Copyright © 2020, ABC Audio. All rights reserved.


jewhyte/iStockBy OLIVIA RUBIN, ABC News

(NEW YORK) -- The leaders of over 75 children's hospitals across the country on Monday asked the federal government for more funding to help sustain their operations and offset the "catastrophic loss" they have faced during the coronavirus pandemic.

"To sustain this critical infrastructure for our nation’s children, we ask you to release a further immediate tranche of funding that includes relief for our children’s hospitals," the letter to Health and Human Services Secretary Alex Azar said. "Our losses continue to grow and our ability to contain the damage to children’s programs decreases with every day that passes."

America’s children’s hospitals have experienced an over 40% decline in revenues and are currently incurring approximately $2 billion in losses per month, according to the letter. The hospitals are "grateful" for the money they have received so far, but said they need more now.

Hospitals across the entire healthcare system have been facing serious financial losses since the coronavirus pandemic swept the nation after cutting lucrative elective surgeries, transforming facilities and purchasing supplies and equipment in order to care for coronavirus patients. In some cases, facilities have been forced to furlough or lay off staff in the exact time that health care workers are desperately needed.

Children are believed to generally experience milder symptoms of COVID-19, but in the letter, the leaders from hospitals including St. Jude Children’s Research Hospital in Tennessee, New York University Langone Health, and Boston Children’s Hospital emphasize they took the same costly protective measures as other health care systems.

And children's hospitals are in an especially challenging position, the letter said, because some of the federal relief funding does not adequately support Medicaid, from which the hospitals draw most of their revenue. Medicaid is the federal program to provide medical coverage for low-income people, including children in low-income families. Facilities that service those with Medicare, the federal program generally for seniors, were allocated tens of billions by the initial relief package.

"We stand shoulder-to-shoulder with our adult hospital counterparts and share many of the same burdens, yet children’s hospitals are unique in the health care ecosystem," the letter to Azar stated. "All the national relief benefits advanced through the Medicare program cannot reach or support our children’s hospitals."

Ultimately, the letter said that "continued delays in relief allocations are having very real repercussions for the children and families we serve."

A representative for HHS did not immediately respond to a request for comment for this report.

The letter does not discuss a new worry among some child health care providers: an extremely rare but serious inflammatory condition in some children that's believed to be linked to the coronavirus. Late last week ABC News reported more than 200 cases of confirmed or suspected cases of what the Centers for Disease Control and Prevention calls Multisystem Inflammatory Syndrome in Children (MIS-C).

A spokesperson for the group told ABC News the MIS-C concern "has not factored in to the current" request, but given the condition is emergeing there is concern that "as schools plan re-openings, cases could increase if COVID-19 spreads in a pediatric population."

Generally speaking, Joan Alker, the Executive Director of the Center for Children and Families (CCF) at Georgetown University, said she is "extremely concerned" about the state of pediatric infrastructure, which has only been weakened during the pandemic.

"We really need a national strategy we need our leaders to sort of thoughtfully consider and address this wide range of threats that children face right now to their health and development," Alker said. "And unfortunately there's just no sign that exists right now."

Alker said more money to fund Medicaid programs will be "critical" in the effort.

"[Medicaid is] serving our most vulnerable children, it's serving our children who have serious chronic health conditions who are most at risk of COVID many of those families have Medicaid is a wrapper around their employer coverage," Alker said. "And it's disproportionately serving communities of color who are being hit hardest by this by this epidemic."

Alker also echoed calls for the administration to act "immediately," stating "they're saying they're addressing it, but it's happening way too slowly."

Copyright © 2020, ABC Audio. All rights reserved.


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