Health News

Four things to know about omicron and holiday travel, gatherings


(NEW YORK) -- Just as hope rose that this year's holiday season would inch back to pre-pandemic normalcy, the omicron variant of the virus that causes COVID-19 entered the picture , raising questions for many people.

Cases of the omicron variant have been confirmed in more than a dozen states across the country.

It comes as, for the first time in two months, the United States is now averaging more than 100,000 new cases per day, according to federal data.

Here are four things to know to help plan ahead for holiday gatherings and travel.

1. Vaccines are the best protection against omicron.

While researchers are still learning more about the omicron variant, it appears so far that being vaccinated helps protect people from getting severely sick, according to Dr. Ashish Jha, dean of the Brown University School of Public Health.

"My sense is you've gotten two shots or been previously infected [with COVID-19], you'll probably end up having a much milder course," he said. "[With] a booster, you'll do even better."

"If you have nothing, no vaccine, not previously infected, I'm not sure it will be a milder disease for you," he said.

Similarly, a study released Wednesday by Pfizer-BioNTech found that being vaccinated with a booster furthers one's protection against omicron.

The study, which was not peer-reviewed, found that omicron likely reduces efficacy of the Pfizer-BioNTech vaccine but does not render it ineffective and that a third dose offers even greater protection against the new variant.

2. Travel remains 'pretty safe' if vaccinated.

For people hoping to travel to see loved ones this holiday season, they should be sure to get vaccinated first, according to Jha.

"For most Americans, if you're fully vaccinated, especially if you're boosted, I think travel is pretty reasonable, pretty safe," he said. "Obviously wear good masks on the airplane, all of the things that we say, but it's still a pretty safe thing to do."

3. COVID-19 testing should be used ahead of holiday gatherings.

The Centers for Disease Control and Prevention on Monday updated its guidance on COVID-19 testing and is advising people, even those who are vaccinated, to get a test before they head to an indoor gathering.

The agency said a rapid test ahead of a gathering is important if the gathering includes unvaccinated children and older people who are more vulnerable to COVID-19.

"Even if you don't have symptoms and have not been exposed to an individual with COVID-19, using a self-test before gathering indoors with others can give you information about the risk of spreading the virus that causes COVID-19," the CDC said in its guidance.

President Joe Biden announced a new plan last week for a winter coronavirus strategy that includes making at-home rapid tests free.

4. If you don't know vaccination status at a gathering, wear a mask.

In cases of a small holiday gathering where you know everyone attending is fully vaccinated, it is safe to not wear a mask while celebrating indoors, according to Dr. Anthony Fauci, White House chief medical adviser.

But if you are at a gathering where you do not know the vaccination statues of everyone attending, Fauci recommends protecting yourself and others by wearing a face mask.

"When you are in a public congregate setting in which you do not know the status of the vaccination of the people involved, it is very prudent to wear a mask, and that's what I do," he said at a Dec. 1 White House press briefing. "Sure, when you're eating and when you're drinking, take the mask down, but to the extent possible, keep it on when you're in an indoor congregate setting."

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Connecticut seeing 'extremely concerning' spike in COVID-19 hospitalizations

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(HARTFORD, Conn.) -- Connecticut has seen an "extremely concerning" rise in COVID-19 hospitalizations in recent weeks, health officials said, as the number of cases also continues to trend up.

The state health department reported at least 500 hospitalizations on both Monday and Tuesday, marking a roughly 80% increase in the past two weeks -- and the highest numbers since April.

"To go from 300 hospitalizations to 500 hospitalizations in such a short period of time is extremely concerning," Dr. Manisha Juthani, commissioner of the Connecticut Department of Public Health, told ABC New Haven affiliate WTNH Tuesday.

The state also reported an 8.3% COVID-19 test positivity rate Tuesday, up from 5.8% the day before, an increase that Connecticut Gov. Ned Lamont called "distressing." Though the governor said he is not so much concerned with the infection rate as he is hospitalizations.

"We have over 500 folks in the hospitals now, so that's triple where we were a few weeks ago," Lamont said on the Connecticut Public Radio show "Where We Live" Tuesday morning. "[It's] one-quarter of where we were a year-and-a-half ago, but it still is reason to be cautious."

The state's COVID-19 test positivity rate, which is the highest it's been in nearly a year, may be elevated due to the use of at-home tests, Juthani said. Negative tests may go unreported, leading to fewer tests overall being factored into the positivity rate. But there is still cause for concern, she said.

"What we can be explicitly clear about is that this is a concerning trajectory that we are headed on in terms of the number of cases we have in our state," Juthani told WTNH.

The health commissioner attributed several reasons to the recent increase in transmission in Connecticut -- and the region in general -- including colder weather, waning immunity among vaccinated residents and indoor gatherings, including holiday celebrations.

"You put all of these factors together, and it is not surprising that we see a rise in cases," she told WTNH. "This virus is equal opportunity, and this virus finds the unvaccinated, primarily, but we do know that breakthrough cases can happen also."

Over 85% of the state's population has gotten at least one dose of the COVID-19 vaccine, according to federal data. The "overwhelming majority" of those who are getting infected are unvaccinated, Lamont said. More severe cases are also largely in those who are unvaccinated; of those currently hospitalized, over 76% are not fully vaccinated, according to state data.

"We need to focus on those that are not vaccinated," Patrick Charmel, president and CEO of Griffin Hospital in New Haven County, told reporters Monday during a press event encouraging vaccination and boosters. "We need folks to go out and protect themselves, because they are protecting the community, but they're also preserving our capacity to take care of sick people."

Amid concerns about the new omicron variant, which has been detected in at least two Connecticut residents, Charmel said the predominant delta variant has been contributing to the current surge in hospitalizations in the state.

"What we are seeing right in, in the increase in hospitalizations over the last two weeks ... that's not because of omicron. That's because of the delta variant that's still with us," he said.

Charmel said Monday that 91% of hospital beds in New Haven County were full, leaving 200 available. Influenza cases are also starting to add another "layer" of strain on hospitalizations in the region, and he urged people to get the flu vaccine as well.

"There isn't the capacity to handle what could come if we don't do the responsible thing," Charmel said.

As cases have gone up in recent weeks, Lamont said he isn't considering implementing any new COVID-19 health orders, such as a universal indoor mask mandate. Currently, only unvaccinated people in the state are required to wear masks while indoors in public spaces. The governor has urged people to avoid large crowds, be cautious and get vaccinated or boosted. He told reporters Tuesday that he is "hopeful" that residents will "continue to do the right thing."

Juthani has also encouraged people to get their boosters to help reduce transmission. About a quarter of eligible residents have gotten their boosters so far, federal data shows.

"Do not let your guard down," she said. "This virus is not done with us, even if we're done with it."

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Women in health care suffer burnout disproportionately to men


(NEW YORK) -- Mounting evidence finds that women working in health care are experiencing disproportionately more feelings of burnout during the pandemic, as they're more likely to carry primary responsibility of family care such as meal preparation, shopping and family activities -- on top of caring for their patients.

A recent study in The Lancet found nearly half of female U.S. health care workers -- 49.4% -- experienced burnout, compared to 41.5% of men. Also more common among women was self-reported prevalence of some mental health issues, with 39.3% of women reporting experiencing anxiety and depression, compared with 26.4% of men. On the flip side, more men -- 55.5% -- said they felt valued by their organizations, compared with 45.9% of women.

"Before the pandemic, I had some work-home balance and was beginning to experience some burnout, but this was magnified during the pandemic," said Dr. Maritza Brown, a board certified nephrologist and associate program director of inpatient medicine at Elmhurst Hospital in Queens, New York. She was a physician on the front lines at Elmhurst, one of the hardest hit hospitals during the onset of the pandemic.

During the initial rise of the novel coronavirus, Brown found herself in a difficult situation of caring for many sick patients on the front lines, then coming home after a demanding hospital shift to carry out her responsibilities as a mother. Luckily Brown's family stepped up for her, including her sons, who helped take care of the housework before she got home from her shifts.

"My family did more of the caring than I did," she said. "They took over all the house chores and insisted that I rest while I was home."

Burnout in health care was already a major problem prior to the pandemic. Doctors and other health care staff are often expected to be available 24/7, leading to an unhealthy work-life balance.

Burnout is more likely among female physicians due to gaps in career advancement, unequal pay and expectations about family and child care, relative to men.

"When individuals are burned out, they're fatigued, they have no energy, they feel completely depleted. The demands that are placed upon them outweigh their resources," said Dr. Janet Taylor, a board-certified psychiatrist in Sarasota, Florida. "They really feel like they are just completely stuck."

All of these problems compounded when the pandemic hit. Many women in health care feel the system has failed them.

"An approach to personal resilience will fail miserably when trainees meet dysfunctional systems that perpetuate clinician burnout," said Dr. Vineet Arora, who has worked on this issue as the dean of medical education at University of Chicago.

"We can't teach a canary to be more resilient in the same coal mine. We have to change the environment to foster a culture of well-being. We need to shift our focus to building a more resilient coal mine," added Dr. Heather Farley, chief wellness officer at ChristianaCare.

Burnout in health care affects everyone -- from doctors to patients to family members. That's because when health care professionals are burned out, they make mistakes. Many quit.

"When the health care teams are burned out, there are more medical errors, lower patient satisfaction, poorer communication and worse patient outcomes," said Dr. Susan Hingle, an internal medicine physician at the Southern Illinois University School of Medicine and the associate dean for human and organizational potential, with a focus on wellness in health care staff.

Fixing burnout among female health care workers won't be easy, experts say. The first step is talking about it openly so women feel less shamed and more encouraged to seek help. Next is addressing systemic issues like wage inequality. For instance, a 2013 study published in JAMA Internal Medicine found an annual pay gap of $51,315 between male and female physicians at U.S. public medical schools.

"I emphasize to all of my students that if they are feeling burned out, it is not a failure on their part, but due to a system that many of us are working on trying to change," said Dr. Shikha Jain, a board-certified hematology and oncology physician and assistant professor of medicine at the University of Illinois Cancer Center in Chicago. "Hospitals and institutions must start valuing their health care workers as more than just cogs in a wheel."

Some large medical organizations are encouraging health care professionals to seek help themselves and watch out for one another.

"Talk to a psychologist or psychiatrist or coach if you find that you are approaching a state of burnout, to ask for help," Taylor said. "So often as women, and in particular, professional women, we feel like we have to be super women and don't ask for the help that we need."

Alexis E. Carrington, M.D. is an ABC News Medical Unit associate producer and a rising dermatology resident at George Washington University. Dr. Jay Bhatt is an internist, instructor at UIC School of Public Health and an ABC News contributor.

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White House issues nationwide call to action on maternal health crisis


(NEW YORK) -- The Biden administration on Tuesday issued a "nationwide call to action" on the maternal health crisis in the United States, which continues to have the highest rate of maternal mortality among developed nations, according to researchers.

Vice President Kamala Harris said in remarks at the White House's first Maternal Health Day of Action that the call to action is being made to both the public and private sectors.

"This challenge is urgent, and it is important, and it will take all of us," Harris said, kicking off a summit that convened lawmakers, Cabinet secretaries and celebrities, including Olympian Allyson Felix. "To put it simply, in the United States of America, in the 21st century, being pregnant and giving birth should not carry such great risk."

"But the truth is, and this is a hard truth, women in our nation are dying before, during and after childbirth," she said.

Harris announced Tuesday a new initiative in which hospitals across the country will be rated on the quality of their maternal health care and designated as "Birthing-Friendly" hospitals if they meet the criteria.

In addition, Harris said the administration has received pledges from more than 20 companies and nonprofits to invest more than $20 million in maternal health efforts in the U.S. and more than $150 million globally. The organizations supporting the effort range from Uber, Lyft and DoorDash to Pampers, CVS, the March of Dimes, the American College of Obstetricians and Gynecologists and the Blue Cross Blue Shield Association, according to the White House.

"They have pledged to invest in remote care monitors for rural communities, to invest in innovative care models for the postpartum period, to invest in education programs for maternal health providers and so much more," she said.

The vice president, who introduced several pieces of legislation on maternal health during her time in the U.S. Senate, also touted the $3 billion investment in maternal health in the Build Back Better Act, which passed the House of Representatives in November but remains stalled in the Senate.

In addition to the $3 billion in funding, one maternal health provision in the legislation includes allowing states to establish "maternal health homes" to coordinate care for people before, during and after birth, according to the White House.

Chiquita Brooks-LaSure, administrator for the Centers for Medicare & Medicaid Services, also announced Tuesday that the agency is releasing new guidance to help states implement a new option, available April 1, 2022, that will allow them to extend Medicaid postpartum coverage from the current 60 days after birth to 12 months.

"This postpartum period is a very crucial time, with more than half of pregnancy-related deaths taking place after birth," Brooks-LaSure said. "That makes maintaining continuous Medicaid or CHIP [Children's Health Insurance Program] coverage and ensuring people can access the care they need during the postpartum period a critical issue."

Tuesday's summit marks the administration's latest effort to draw attention to the issue of maternal mortality. In April, President Joe Biden issued the first presidential proclamation for Black Maternal Health Week.

At that time, Harris led a roundtable discussion with women of color affected by the maternal mortality crisis.

Black and Native American women in the U.S. are two to three times more likely to die during childbirth or in the months after than white women, according to the Centers for Disease Control and Prevention.

Black women are also more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.

Pregnancy-related deaths are defined as the death of a woman during pregnancy or within a year of the end of pregnancy from pregnancy complications, a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiological effects of pregnancy, according to the CDC.

One reason for the disparity is that more Black women of childbearing age have chronic diseases, such as high blood pressure and diabetes, which increases the risk of pregnancy-related complications like preeclampsia and possibly the need for emergency C-sections, according to the CDC.

But there are socioeconomic circumstances and structural inequities that put Black women at greater risk for those chronic conditions, data shows, and Black women often have inadequate access to care throughout pregnancy, which can further complicate their conditions, according to a 2013 study published in the American Journal of Obstetrics and Gynecology.

In her remarks, Harris called the "systemic inequities" that affect pregnant people of color a "matter of life and death."

She also drew attention to how the issue of maternal mortality affects people who live in rural areas with limited access to care, saying they are 60% more likely to die from pregnancy-related complications.

"Regardless of income level, regardless of education level, Black women, Native women, women who live in rural areas are more likely to die or be left scared or scarred from an experience that should be safe and should be a joyful one," Harris said. "And we know a primary reason why this is true, systemic inequities, those differences in how people are treated based on who they are and they create significant disparities in our health care system."

Last December, in the final weeks of the Trump administration, the Department of Health and Human Services launched an action plan to combat the high rates of pregnancy-related complications and deaths.

The plan set out three key targets aimed at improving maternal health by 2025: reducing maternal mortality rate by 50%, reducing low-risk cesarean deliveries by 25% and controlling blood pressure in 80% of reproductive age women.

Also last year, the Centers for Disease Control and Prevention launched the "Hear her" campaign with the goal of creating public awareness of the warning signs of pregnancy emergencies.


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Number of omicron cases in US 'likely to rise,' CDC director says

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(ATLANTA) -- With the omicron variant now detected in at least 16 states in the U.S., Centers for Disease Control Director Dr. Rochelle Walensky said the agency is "following them closely" and that the number is "likely to rise."

Walensky told This Week co-anchor Martha Raddatz that the CDC is still uncertain how transmissible the new variant is and how effective approved COVID-19 vaccines will work against it.

"We know it has many mutations, more mutations than prior variants," she said. "Many of those mutations have been associated with more transmissible variants, with evasion of some of our therapeutics, and potentially evasion of some of our immunity, and that's what we're watching really carefully."

The main concern right now, according to Walensky, is the dominant delta variant in the U.S. and the thousands of cases being diagnosed each day.

"We have about 90 to 100,000 cases a day right now in the United States, and 99.9% of them are the delta variant," she said.

But South African studies have so far shown that omicron is about twice as transmissible as delta, and when pressed by Raddatz on what that means for the next six months in the U.S., Walensky said it depends on how the public mobilizes together.

"We know from a vaccine standpoint that the more mutations a single variant has, the more immunity you really need to have in order to combat that variant, which is why right now we're really pushing to get more people vaccinated and more people boosted to really boost that immunity in every single individual," Walensky said.

She said the CDC is "hopeful" that current vaccines will work to at least prevent severe disease and keep people out of the hospital.

Moderna is currently working on an omicron-specific booster should it be needed and Stephen Hoge, president of Moderna, said it could be ready early next year.

In an exclusive interview with Raddatz last week, Hoge said that a new variant-specific vaccine would be needed if the level of efficacy dropped below 50%.

Efficacy is a "really interesting, important question, but efficacy is sort of in itself on a spectrum," Walensky said.

"Is it efficacy of preventing disease entirely? Preventing infection entirely, even if it just leads to a runny nose? Or is it efficacy of making sure people stay out of the hospital and prevent death?" Walensky questioned. "Certainly, we want to do the latter, absolutely first. And we'd really like to do the former as well."

Walensky also said that the Food and Drug Administration is already in "conversations" with vaccine makers to streamline the authorization process of an omicron-specific booster and that the CDC would be moving "swiftly" after that approval.

When Raddatz asked how the U.S. can help to get even more shots into arms around the world and whether the omicron variant would have even appeared if more people in South Africa were vaccinated, Walensky touted U.S. donation efforts.

The Biden administration has pledged to donate more than 1 billion vaccine doses. According to the Kaiser Family Foundation, as of Dec. 5, over 237 million doses have been delivered, 45 million have been shipped, leaving nearly 817 million pledged doses yet to be distributed. The White House has pledged to deliver 200 million more doses in the next 100 days to countries in need.

"We're not only donating the vaccines for free and providing more vaccines to the globe than any -- than every other country combined, but we at CDC work in 60 other countries providing on the ground assistance in vaccine safety and vaccine delivery and vaccine confidence, in vaccine effectiveness studies."

Pressed by Raddatz if she fears a worst case scenario is possible with the omicron variant, Walensky said health experts are better situated to tackle the virus now than when it first appeared.

"We have so many more tools now than we did a year ago," she said. "We know so many things that work against SARS-CoV-2, the virus that causes COVID, regardless of the variant that we've seen before."

Walensky said getting immunity from the COVID-19 right now is "critically important" and continued to stress the importance of CDC regulations such as masking up in areas with high or substantial transmission.

The CDC director dismissed the idea of a nationwide mask mandate when Raddatz asked and said she’d "rather see people get vaccinated, boosted and follow our recommendations."

"I'd rather not have requirements in order to do so," she said. "People should do this for themselves."

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With so many unknowns about omicron, when will we have answers?


(NEW YORK) -- The latest COVID-19 variant of concern, omicron, first reported to the World Health Organization from South Africa last week -- and now detected throughout the U.S. -- continues to worry many Americans with still much unknown about the virus.

Health authorities continue to urge calm as scientists across the globe search for answers.

"Right now, we're really in a state of knowledge acquisition," said Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Massachusetts. "We really need to know more. We need to know how pathogenic it is. We need to know how transmissible it is and we need to know whether or not it evades antibody responses induced by the vaccines."

Experts caution that answers to those questions may not come for months.

"What's going to happen is our band of confidence is going to narrow over time as opposed to saying in this amount of time we will have an answer. And that's what we have to recognize," said John Brownstein, epidemiologist and chief innovation officer at Boston Children's Hospital. "We just need to have some patience," Brownstein added.

When will we know about omicron transmission?
Researchers, however, expect to have estimates for transmissibility "probably ahead of some of the other questions that we have," said Brownstein.

In a press conference Wednesday, WHO COVID technical lead, Dr. Maria Van Kerkhove, said there is some suggestion omicron may be more transmissible but it's too early to say definitively. "We expect to have more information on transmission within days, not necessarily weeks," Van Kerkhove said.

"Based on the data collected through surveillance, we have a rough estimation of the proportion of infections that relate to omicron where you can start to make basic estimates of transmissibility very quickly," said Brownstein.

During the White House COVID-19 briefing on Friday, Dr. Anthony Fauci, the White House's chief medical adviser, said as more omicron cases are detected, the Centers for Disease Control and Prevention would be able to model how the new variant will spread, similar to how quickly CDC predicted the delta variant would spread from the initial 3% to 4% of cases to nearly all cases.

"We really don't know what's going to happen, how well it is going to compete or not compete with delta, but we will know as more cases occur and what the doubling time of the relative percentage of omicron versus delta will be," Fauci said.

When will we know how effective current COVID-19 vaccines are on omicron?
The Food and Drug Administration said in a statement on Tuesday it is working "as quickly as possible" to evaluate the potential impact of omicron on current treatments, vaccines and tests and said it expects to have answers in the next few weeks.

If a modification to current vaccines is necessary, vaccine manufacturers say they are prepared to make those modifications quickly.

In a statement on Sunday, Pfizer and BioNTech said they have been monitoring the effectiveness of their vaccine against emerging variants and if a "vaccine-escape variant emerges" they expect to be able to make a "tailor-made vaccine against that variant in approximately 100 days, subject to regulatory approval."

Matt Barrows, Moderna's senior director of manufacturing told ABC News that the company has the capacity to produce an omicron-specific booster vaccine within a month if it becomes necessary. He said experiments testing the efficacy of their current vaccine against omicron are ongoing and will take at least two to three weeks.

“Although we haven't proven it yet, there's every reason to believe that if you get vaccinated and boosted that you would have at least some degree of cross protection, very likely against severe disease, even against the Omicron variant,” said Fauci.

When will we know if omicron causes more serious illness?
Learning if this version of the virus is deadlier could take many months, experts say.

"We don't even know if omicron will have the ability to overtake delta and we're dealing with a delta surge right now. There's a lot of ifs and a lot of open questions," said Brownstein.

Currently, the delta variant is driving nearly all cases across the U.S., with 99.9% of cases in the country from the delta variant.

Health officials are encouraged by the mild symptoms the omicron cases are experiencing so far. According to health officials, the man who tested positive for omicron in Minnesota is fully vaccinated and had been boosted in early November. The woman identified in Colorado is also reported to be experiencing only mild symptoms and was fully vaccinated, however not boosted.

Early cases identified in South Africa have also reported no severe disease according to local officials. "Right now it does not look like there's a big signal of a high degree of severity, but it's too early to tell," said Fauci, in an interview with CNN.

As of today, there are more than 400 confirmed cases of Omicron in over 30 countries across the globe, including in the US. As scientists work on getting more answers, experts are urging to not wait and get vaccinated or boosted if eligible.

"As it stands now with the information we have, you do the best with the information you have in front of you and that information says that you get an incredible advantage by getting that booster," said Brownstein.

Barouch said that the only way to stop new variants is to vaccinate people across the globe.

On Friday, the White House announced that it's shipping out 11 million more vaccines worldwide in an effort to increase vaccination around the world. The U.S. has shipped 291 million doses so far and President Joe Biden announced plans Thursday to provide 200 million more doses worldwide in the next 3 months.

"Currently, sub-Saharan Africa has less than a seven percent vaccination rate. And so it's not a surprise that new variants are emerging in that part of the world," Barouch said. "The only way to stop these variants is to have a widespread vaccination campaign that really reaches all four corners of the planet."

Esra Demirel, M.D., is an OB-GYN resident physician at Northwell Health-North Shore University Hospital & LIJ Medical Center and is a contributor to the ABC News Medical Unit.

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As delta continues to surge in Pennsylvania, hospital officials urge vaccination


(PENNSYLVANIA) -- Omicron has been making headlines as cases of the new COVID-19 variant continue to be detected in the United States. While the strain is concerning, health officials are heeding that delta continues to fuel widespread transmission and is a problem now.

That's the current case in Pennsylvania, where the number of daily confirmed COVID-19 infections crossed 10,000 Friday for the first time since the state's winter wave.

In the past week, the number of COVID-19 cases, case rates, hospitalizations and patients on ventilators have all gone up, according to state data. Amid its latest surge, Pennsylvania has one of the highest COVID-19 hospitalization rates in the U.S.

"We continue to see a tremendous amount of COVID-19 patients," Dr. Eugene Curley, the medical director of infectious disease for WellSpan Health, which has six acute care hospitals in south-central Pennsylvania, told ABC News.

One month ago, there were about 250 COVID-19 patients total being treated across the six hospitals; on Friday, that number was 310, Curley said. The peak, during last year's winter surge, was around 430, he said.

The University of Pittsburgh Medical Center, which operates over 35 hospitals throughout Pennsylvania, has seen its second-highest number of COVID-19 patients since the pandemic began, hospital officials said. As of Friday morning, there were 779 patients with active COVID-19 infections admitted across all UPMC facilities; the peak, in December 2020, was 1,250, UPMC Chief Medical Officer Dr. Donald Yealy told ABC News.

"Across our system, we're at about two-thirds to three-quarters of what that peak is," he said. "So it is very, very brisk."

The state's current surge has been building since late summer, Yealy said. It reached a peak in late September before "there was the beginning of a pullback in activity," Yealy said.

"That pullback no longer exists and we are back on essentially an upward trajectory," he continued.

It's hard to predict if Thanksgiving gatherings will have an impact on hospitalizations; holidays are a "wild card," Curley said. But many people in the state have no protection against COVID-19, Yealy noted, which will help fuel transmission.

Statewide, around 41% of residents have still not gotten fully vaccinated, according to federal data. Within some counties, that percentage is in the 60s, state data shows.

Unvaccinated people continue to represent the vast majority of hospitalized COVID-19 patients, including those who are in intensive care units, state and hospital data shows.

For the 30 days ending Nov. 2, nearly 75% of people hospitalized due to COVID-19 were unvaccinated, according to state data.

Across WellSpan's six acute-care hospitals, over 90% of COVID-19 patients in the ICU and on ventilators since early September have been unvaccinated, the health system said this week.

"Those numbers just reinforce what we already know -- is these vaccinations are safe and effective," Curley said.

Pennsylvania Gov. Tom Wolf has urged people to get vaccinated if they haven't already.

"In Pennsylvania and around the country, the vaccine is still our strategy, so get your shot," the governor said last week on KDKA-AM radio, according to The Associated Press.

A renewed push for vaccination and boosters has come amid the spread of omicron, which has concerned scientists due to its large number of mutations. The variant has been detected in at least 11 states -- including Pennsylvania, where the state's first case was identified Friday in a man from northwest Philadelphia, health officials said.

For Curley, if concerns around the omicron variant encourage people to get vaccinated, that's a good thing. But he warned that delta "is here now."

"People need to get vaccinated for that reason," he said. "If you're out there and you're eligible to be vaccinated, get vaccinated now because of delta."

Rochelle Walensky, director of the Centers for Disease Control and Prevention, echoed that sentiment on Friday in an interview on CNN.

"We now have about 86,000 cases of COVID right now in the United States being diagnosed daily and 99.9% of them, the vast majority of them, continue to be delta," she said. "And we know what we need to do against delta. And that is get vaccinated. Get boosted if you're eligible and continue all of those prevention measures, including masking."

It is too soon to tell if omicron will overtake delta as the predominant variant in the U.S., she said. Though either way, the actions will likely remain the same, experts say.

"The truth of the matter is, both delta, which is the predominant variant now, and omicron are easily transmitted. And so the concerns are really not changed all that much, and the actions that we all need to take remain exactly the same," Yealy said. "Get vaccinated, wear a mask indoors and in crowds, keep a little distance and if you get sick, don't go out with others and get tested as quickly as possible."

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Amy Coney Barrett raises adoption in abortion case hearing that poses challenge to Roe v. Wade

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(WASHINGTON) -- When the U.S. Supreme Court heard arguments Wednesday over a Mississippi law that would ban most abortions after 15 weeks of pregnancy, a headline-making line of questioning came from the court's newest justice, Amy Coney Barrett.

Barrett, a conservative justice appointed last year by former President Donald Trump, questioned whether adoption rather than abortion could resolve the “burdens of parenting” noted in Roe v. Wade and Casey v. Planned Parenthood, the two major Supreme Court rulings on abortion that protect a woman's right to end a pregnancy before fetal viability.

Since Roe v. Wade was decided in 1973, the Supreme Court has never allowed states to prohibit the termination of pregnancies prior to fetal viability outside the womb, roughly 24 weeks, according to medical experts.

During Wednesday's arguments, Barrett, a mom of seven with two adopted children, questioned Julie Rikelman, a Center for Reproductive Rights attorney arguing against Mississippi’s 15-week ban, about safe haven laws, which protect parents from criminal prosecution if they leave unwanted infants at designated places, like hospitals. All 50 States, the District of Columbia, and Puerto Rico have enacted safe haven legislation, but rules and regulations vary by state, according to the Department of Health and Human Services' Children's Bureau.

"Insofar as you and many of your amici focus on the ways in which forced parenting, forced motherhood, would hinder women's access to the workplace and to equal opportunities, it's also focused on the consequences of parenting and the obligations of motherhood that flow from pregnancy," said Barrett. "Why don't the safe haven laws take care of that problem?"

"It seems to me that the choice more focused would be between, say, the ability to get an abortion at 23 weeks or the state requiring the woman to go 15, 16 weeks more and then terminate parental rights at the conclusion," she said. "Why -- why didn't you address the safe haven laws and why don't they matter?"

Rikelman responded by pointing out the unique risks that pregnancy alone carries, saying in court, "We don't just focus on the burdens of parenting, and neither did Roe and Casey. Instead, pregnancy itself is unique. It imposes unique physical demands and risks on women and, in fact, has impact on all of their lives, on their ability to care for other children, other family members, on their ability to work."

It is a point echoed by reproductive physicians, who say talking about adoption in place of abortion misses the realities of people's lives and the dangers of pregnancy.

If the Supreme Court were to uphold the Mississippi ban, as the conservative majority appeared headed toward, legal scholars say it could clear the way for stringent new restrictions on abortion in roughly half the country.

"'I'm unfortunately not surprised that adoption was brought up so much, because I think people feel that pregnancy is this non-issue medical condition," said Dr. Leilah Zahedi, a Tennessee-based maternal fetal medicine specialist and fellow with Physicians for Reproductive Health. "It's very infuriating to be honest, because it shows their ignorance in the fact that pregnancy is not an uncomplicated condition for the majority of the United States."

"Pregnancy is probably one of the most dangerous things a woman does in her life, bar none," she said.

The U.S. is also a particularly dangerous place to give birth. It has the highest maternal mortality rate among developed countries, according to a 2020 study from the Commonwealth Fund, a healthcare policy-focused nonprofit organization.

Black women are three to four times more likely to die during childbirth or in the months after than white, Asian or Latina women, while Indigenous women are two to three times more likely, according to the Centers for Disease Control and Prevention.

Physicians like Dr. Nisha Verma, a board-certified OBGYN who provides abortion care, point out that abortion, on the other hand, is "incredibly safe."

"The risk of childbirth is as high as 10 times higher than the risk of abortion," said Verma, also a fellow with the American College of Obstetricians and Gynecologists. "That's a lot of risk to ask someone to take on."

The American College of Obstetricians and Gynecologists was among 25 medical organizations who together filed an amicus brief in the Dobbs v. Jackson Women's Health case that is now before the Supreme Court, arguing the Mississippi law is "fundamentally at odds with the provision of safe and essential health care, with scientific evidence, and with medical ethics."

Providers like Verma also point to statistics showing that restrictions on abortion impact people who are the most vulnerable to complications from pregnancy and childbirth.

Around 75% of abortion patients are low-income residents, and nearly 60% of U.S. women of reproductive age live in states where access to abortion is restricted, according to the Guttmacher Institute, a reproductive rights organization.

In her response to Barrett, Rikelman cited the maternal mortality statistics in Mississippi alone, saying, "It's 75 times more dangerous to give birth in Mississippi than it is to have a pre-viability abortion, and those risks are disproportionately threatening the lives of women of color."

In addition to the physical risks people face during pregnancy, there are also other factors to consider, like the lack of safeguards for pregnant people in the U.S., experts say.

The U.S. does not have universal health care and does not provide universal child care. And as the Supreme Court weighs its decision on the Mississippi law, the U.S. remains the only industrialized, modernized country in the world without federally mandated paid family leave, according to data compiled by the Organization for Economic Cooperation and Development.

The House of Representatives last month passed a social spending plan that includes four weeks of paid family leave, eight weeks less than what was in the original spending package proposed this year by President Joe Biden. But that bill faces an uphill battle in the Senate, with Sen Joe Manchin, D-W.Va., a critical vote, opposed to the paid leave provision.

"Abortion is not an isolated political issue," said Verma, weighing in on Justice Barrett's specific comments on adoption. "I think the way that adoption was presented as just this easy alternative to abortion completely disregards the real experiences that people are having. It's a decision that's happening in the context of people's lives."

In the majority of cases when providers talk to pregnant people about the option of abortion, they also provide them with information on the option of adoption, according to Verma. She said, in her experience, a person's decision on their own pregnancy is not one made lightly, and is not one made without considering all options.

"The decision-making process is different for every person, but it is a decision that people are making carefully and intentionally with all of the information and in the context of their own lives," she said. "It's not something that we can impose on people."

Verma continued: "I see patients all the time making decisions to have an abortion from a place of love and compassion."

There were over 620,00 legal induced abortions in the U.S. in 2019, the most recent data available, according to the CDC. At the end of the same year, 2019, there were around 122,000 children waiting to be adopted out of the U.S. foster care system, government data shows.

Overall, just over 110,000 adoptions took place in the U.S. in 2014, the most recent data available, according to the National Council for Adoption, a national advocacy organization that promotes adoption.

Ryan Hanlon, acting CEO and president of the National Council for Adoption, said the organization does not have a position on Dobbs v. Jackson Women's Health.

Speaking specifically on safe haven laws, Hanlon said the goal should be to meet pregnant people and provide them with comprehensive information before they would find themselves in what he described as the "crisis" of leaving a child under the law.

"Safe haven laws can be a really wonderful thing, but by the time we've gotten to that point, we've already experienced a crisis," he said. "What I would hope for any woman who's experiencing an unplanned pregnancy is that she's getting information and support well before then, and for those women who do choose to place their child for adoption, that they are getting support before, during and after the birth."

ABC News' Devin Dwyer contributed to this report.

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What is known about the omicron variant that's arrived in the US


(NEW YORK) -- As health officials expected, the United States has now confirmed several cases of the omicron variant, which was first identified in Botswana and has since been detected in at least 35 counties.

The World Health Organization declared omicron a variant of concern on Friday. Earlier this week, the agency said the overall global risk is "very high" due to the variant's large number of mutations, including on the spike protein of the virus, though there are still many unknowns, including information on its transmissibility, severity and impact on immunity.

Here's what we know so far about the variant in the U.S.:

First states to detect cases

The first three cases of the omicron variant identified in the U.S. were detected in fully vaccinated Americans with recent travel histories. All three people experienced mild symptoms, health officials said.

The first case was detected in California in an individual who had returned from South Africa on Nov. 22. The person, who was not yet eligible for a booster dose, sought COVID-19 testing a few days upon returning to San Francisco after developing symptoms, and genomic sequencing testing confirmed the case to be omicron on Wednesday, health officials said. All close contacts have been contacted and have tested negative.

Colorado confirmed a case of the omicron variant Thursday in a woman from Arapahoe County who had recently traveled to southern Africa. State epidemiologists had flagged the testing specimen for genome sequencing due to the recent travel history. The resident was eligible for a booster but had not yet received it, health officials said.

Through its regular surveillance of COVID-19 case specimens, Minnesota detected an omicron case Thursday in a Hennepin County resident who had recently traveled to New York City to attend the Anime NYC 2021 convention from Nov. 19 to 21. The man, who had received a booster dose in early November, developed mild symptoms on Nov. 22 and sought testing on Nov. 24. It seems likely that the transmission occurred at the NYC convention, but that is not certain, health officials said. His symptoms have since resolved. A close contact tested positive for COVID-19, though tests to confirm if that is also omicron have yet to be conducted, health officials said.

Thursday evening, New York Gov. Kathy Hochul announced that at least four cases of the omicron variant had been detected in the state. They included a 67-year-old, fully vaccinated woman in Suffolk County who recently traveled from South Africa, and then three residents in New York City. A fifth case is also suspected to be omicron, Hochul said. All cases are mild.

A second California case was also announced Thursday evening, in a fully vaccinated Los Angeles County resident who had returned from South Africa on Nov. 22, health officials said. The infection "is most likely travel-related," the Los Angeles County Department of Public Health said.

The detected cases illustrate the need to seek out testing based on travel history and symptoms, as well as the importance of sharing travel history with public health officials, health experts said. The Centers for Disease Control and Prevention currently advises that people who recently traveled internationally should get tested three to five days upon their return regardless of symptoms or vaccination status. NYC officials have also encouraged all attendees of the Anime NYC 2021 convention, estimated to be around 53,000, to get tested immediately and take precautions such as social distancing.

No cause for panic

Health experts have said the presence of the omicron variant in the U.S. is not surprising, and while concerning, it is not a reason to panic.

"At this point, I'm not terribly alarmed," Colorado Gov. Jared Polis told reporters Thursday during a briefing on the omicron case.

The governor said that if community transmission is occurring in Colorado, it's very small because no omicron variant has been discovered in wastewater analysis yet. Roughly 15% of all positive COVID-19 tests are sequenced in Colorado.

San Francisco Department of Public Health Director Dr. Grant Colfax told reporters during a briefing yesterday that the case was "not a cause for us to panic" and that the city "is prepared" for this.

Leaders in New York and Minnesota had similar messages.

"We're ready for it. This is not surprising," New York Gov. Kathy Hochul said during an on-camera briefing earlier Thursday.

"This news is concerning, but it is not a surprise," Minnesota Gov. Tim Walz said in a statement. "We know that this virus is highly infectious and moves quickly throughout the world."

Minnesota Department of Health Commissioner Jan Malcolm echoed that sentiment during a briefing Thursday, saying omicron is something to take seriously but "not a reason to panic."

"We're at a stage where there is still a lot we need to learn about omicron," she said.

Officials in the cities and states where the variant has been detected have said they don't plan to make any changes to health orders at this time.

Impact on travelers

White House chief medical adviser Dr. Anthony Fauci told reporters Wednesday he doesn't think a domestic flight policy for testing or vaccination due to omicron is necessary right now but said it's always something under consideration.

"These kinds of things we always talk about and consider. But right now, I'm not so sure we need testing for air travel in this country," he said.

There are strengthened requirements for travelers coming to the U.S. amid the spread of the omicron variant. On Thursday, President Joe Biden announced that all passengers must show proof of a negative COVID-19 test within one day of flying into the U.S., regardless of their vaccination status or nationality.

"This tighter testing timetable provides an added degree of protection as scientists continue to study the omicron variant," he said during a briefing.

Unvaccinated Americans already were required to show proof of a negative test within one day of traveling. The new rule, which goes into effect Monday, expands that one-day requirement to all vaccinated travelers coming into the U.S. from other countries. Unvaccinated nonresidents are currently barred from boarding a flight to the U.S.

Delta still dominant

Amid concerns about the omicron variant, health experts have stressed that delta is still a major issue in the U.S., where close to 100,00 new cases are diagnosed daily. Delta comprises 99.99% of new COVID-19 cases.

"I think omicron is another kind of wake-up call, and we needed another one," Malcolm, with the Minnesota Department of Health, said. "Even though we might feel like we're done with the pandemic, it is most certainly not done with us."

Health officials have urged people to get vaccinated and get boosters and to continue to follow COVID-19 guidelines such as wearing a mask indoors while in public, test if you have symptoms and stay home if you're sick.

ABC News' chief medical correspondent, Dr. Jennifer Ashton, told David Muir on Thursday that vaccinations remain the most important tool we have in combatting COVID-19 this winter.

"Some protection is better than none, and while we learn about the many mutations that omicron has ... we have to double down on what we know is going to be our best tool in the toolbox, and that is vaccination," Ashton said.

Regarding boosters, Fauci has urged Americans who are eligible to get the shot now.

"Right now, I would not be waiting," he said Wednesday. "People say, well, if we're going to have a booster-specific vaccine, should we wait? If you are eligible, namely six months with a double mRNA dose, or two months with the J&J, get boosted now."

"We may not need a variant-specific boost," he added.

ABC News' Matthew Fuhrman, Cheyenne Haslett and Arielle Mitropoulos contributed to this report.

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Texas law restricting access to abortion pills goes into effect: What to know


(NEW YORK) -- As the U.S. Supreme Court continues to weigh whether to leave Texas's unprecedented six-week abortion ban, SB8, in place, a new law that also restricts abortion access is going into effect in the state.

Starting Thursday, people in Texas will have a narrower window in which they can receive abortion-inducing medication, including the two most commonly used medications, mifepristone and misoprostol.

Senate Bill 4, or SB4, cuts the window in which physicians are allowed to give the medication from 10 weeks of pregnancy to seven weeks.

The new law also prohibits mailing abortion-inducing drugs, a restriction that contrasts with a federal regulation enacted in April by the Biden administration that temporarily allows the medication to be mailed during the COVID-19 pandemic.

Current Texas law already bans providers from administering medication abortion using telemedicine, according to Abigail R.A. Aiken, MD, MPH, PhD, associate professor of public affairs at the University of Texas at Austin and principal investigator with Project SANA, a research project focused on self-managed abortion in the U.S.

"We've seen many states be able to open up new models of care where clinic-based providers can now do medication abortion by telemedicine," said Aiken. "I think Texas is very clear that they don't want providers here to follow suit and be able to start doing those kinds of new models where you would do a phone consultation with a provider and then have the pills mailed to your house for use at home."

The bill, signed into law by Gov. Greg Abbott on Sept. 24, also adds new requirements around medication abortions, including an in-person examination by a physician, a mandatory follow-up visit within 14 days and new reporting requirements for providers.

The bill also creates a state jail felony offense for "a person who intentionally, knowingly, or recklessly violates provisions relating to abortion-inducing drugs," but exempts pregnant people on whom a medication abortion is "attempted, induced or performed," according to the bill summary.

Though SB4 is being enacted in Texas, medication abortion is now a very common method used for abortions in the first 10 weeks of pregnancy. In 2019, 42% of all abortions in the U.S. were early medical abortions, meaning medications were taken at nine weeks or earlier after conception, according to the Centers for Disease Control and Prevention.

Medication abortions were first approved by the Food and Drug Administration in 2000. FDA guidelines advise that abortion-inducing pills are safe to use up to 70 days, or 10 weeks, after conception, though evidence shows it can be safe even later in pregnancy, according to the American College of Obstetricians and Gynecologists.

In most cases in a medication abortion, mifepristone is taken first to stop the pregnancy from growing. Then, a second pill, misoprostol, is then taken to empty the uterus.

Of the two medications, mifepristone is more restricted by the FDA. Since 2011, the agency has applied a risk evaluation and mitigation strategy to mifepristone, preventing it from being distributed at pharmacies or delivered by mail like other prescription drugs.

It must be ordered, prescribed and dispensed by a health care provider who meets certain qualifications, and may only be distributed in clinics, medical offices, and hospitals by a certified health care provider, according to FDA guidelines.

The FDA's rules, combined with state restrictions like the one in Texas, have the effect of not only limiting when, where and how people can get abortions, but also potentially misguiding people on the safety of medication abortion, according to Dr. Bhavik Kumar, a staff physician at Planned Parenthood Center for Choice in Houston.

"What's important to note is that the medication used in medication abortion has been used in this country for 21 years and it is extremely safe," said Kumar. "We've learned a lot since it was first introduced and can use it in different ways that are more patient-centered, more evidence-informed and really optimizes science and medicine so that patients get the care that they need."

Speaking of the new law now in effect in Texas, he added, "What Senate Bill 4 is doing is inserting itself squarely into my relationship with my patients and telling me how to practice medicine, and it's not in the best interest of my patients. It's actually causing more harm to my patients and it's taking options away from them."

Abortion rights advocates say SB4 also has the likelihood of signaling to other states that further restrictions on medication abortion can be put in place.

In South Dakota in September -- the same month SB4 was signed into law in Texas -- Gov. Kristi Noem, a Republican, issued an executive order directing the state's Department of Health to establish rules requiring that abortion-inducing drugs only be prescribed and dispensed by a state-licensed physician after an in-person examination. Noem said she also plans to pass legislation next year that makes "these and other protocols permanent."

Across the country, more than 30 states require clinicians who administer medication abortion to be physicians, while 19 states require the clinician providing a medication abortion to be physically present when the medication is administered, according to the Guttmacher Institute.

"I think we have to see this is another continuation of the trajectory of trying to really make abortion a right on paper only in the United States," said Aiken. "It's another way of placing barriers in the way of people."

She continued, speaking of restrictive abortion laws in some states, "I think what it's doing in reality is creating this really uneven picture where you have some states that are moving in the direction of more and more and more accessible care, but the reality in other states is completely the reverse, so we're looking at that uneven picture where your access really depends on your zip code."

Both Aiken and Kumar mentioned the affect laws like SB4 in Texas have on the most vulnerable populations.

Around 75% of abortion patients are low-income residents, and nearly 60% of U.S. women of reproductive age live in states where access to abortion is restricted, according to the Guttmacher Institute, a reproductive rights organization.

"It has been the case in Texas now for decades that we have seen low-income people and communities of color just bear this disproportionate brunt of negative impacts of these laws," said Aiken. "So this is an equity issue and it's a justice issue as well as a health care issue."

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What's behind the 'dire' COVID-19 surge in Michigan?


(OKEMOS, Mich.) -- Michigan is in the midst of its fourth COVID-19 wave -- and there is no end in sight, hospital officials said.

Cases and hospitalizations are rivaling levels seen in earlier parts of the pandemic, when vaccines weren't widely available. The surge also comes at a time when non-COVID-19-related patients are being admitted, flu cases are emerging and health systems are understaffed, Brian Peters, CEO of the Michigan Health & Hospital Association, told ABC News.

Unvaccinated people continue to make up the majority of those infected with COVID-19, including severe cases of the infection. Roughly around three-quarters of COVID-19 cases, hospitalizations and deaths were in unvaccinated people from Oct. 21 to Nov. 19, according to state data.

Around 45% of the state remains unvaccinated, according to federal data.

"The situation right here in Michigan is as dire as it has ever been since the start of this pandemic," Peters said.

Michigan reported a nearly 20% positivity rate in the past week, and every county is currently at the state's highest risk level for transmission.

Michigan is not alone in seeing COVID-19 cases and hospitalizations increase due to the delta variant, especially as colder weather has approached, people have gathered indoors more and pandemic fatigue has long set in. Though the duration of this surge, and the speed with which cases have "skyrocketed" in the past three weeks, is alarming, Dr. Darryl Elmouchi, president of Spectrum Health West Michigan, which operates 14 hospitals, told ABC News.

"If you look at most other states, and all the surges we've had, usually you start at a low point and you go up really quickly, and then you come down pretty quickly," he said. "What happened for us is we went up gradually enough, but we went up high enough, with [positivity rates] in the teens, that when we shot up, we shot up from that baseline."

"This has far surpassed anything we've seen before -- both in how long it's been going on, and now its seemingly never-ending peak," he added. "We just don't know when the end will be, and we're very worried it will have a very long tail."

Michigan reported its second-highest number of COVID-19 cases and case rates in the past week, according to the state's latest weekly coronavirus report, released Tuesday. That follows records set in both cases and case rates the previous week. Hospitalized COVID-19 patients also increased 13% during the past week, the report found.

"I felt like probably the surge we had last fall was going to be the worst we've ever seen. I never would have guessed that we would be in yet another surge and that it would be the worst surge yet," Sandra Gilman, a nurse and hospital supervisor for Spectrum Health, told ABC News.

At Spectrum Health West Michigan, unvaccinated COVID-19 patients are generally about nine years younger and only have two comorbidities, as opposed to four, when compared to vaccinated patients, "meaning that they're younger and healthier when they're coming in," Elmouchi said.

"That tells us the importance of being vaccinated," he said. "And that's what's so heartbreaking for our teams, is that they see all these people that are so sick, being on the ventilator and even dying, and they know it's preventable. It's heart-wrenching."

Due to a mix of early nursing retirements, pandemic burnout and a "rising tide of violence" against health care staff, Michigan hospitals are treating the latest surge in COVID-19 patients amid a staffing shortage, according to Peters. There are approximately 875 fewer staffed hospital beds in Michigan than in November 2020, he said.

"That is incredibly concerning, because there's not a rapid or easy solution to that problem," Peters said.

Amid the staffing strain, this week, the Department of Defense temporarily deployed nearly four dozen medical personnel, including registered nurses, doctors and respiratory therapists, to two hospital systems in the state.

The help is welcome, though more is needed, Peters said, especially as the pandemic only worsened an existing health care workforce shortage. Among other measures, his organization is advocating for a $650 million special appropriation in the state legislature that would provide payments to health care staff to encourage them to stay in their jobs, as well as offer incentives for training programs to increase the number of workers in the pipeline, he said.

For now, hospital capacity remains a concern throughout the state, where every region, from urban to rural, is a "hotspot," Peters said.

At Spectrum Health West Michigan, the intensive care units are operating at 147% of their traditional capacity, Elmouchi said.

Statewide, hospitals are operating at almost 85% occupancy, according to state data.

In recent weeks, some hospitals have had to divert patients to other hospitals and delay elective procedures, Peters said.

"That doesn't necessarily create a quality-of-care problem as much as it can be a convenience problem," he said. "But what we're very fearful of, is that if these COVID numbers don't level off and decline, you're going to start seeing real access challenges, where literally there's no more capacity to care for patients, COVID or otherwise, in certain communities."

"We're doing everything we possibly can to avoid that outcome, but without the public's help, that's our future," he added.

Health officials are urging residents to get vaccinated and receive booster shots and to mask up indoors in public settings to help alleviate the surge -- especially amid concerns and questions around the transmissibility and mutations of the new omicron variant, which was first detected in the U.S. Wednesday in California.

"Ensuring that as many Michiganders as possible are vaccinated remains the best protection we have against COVID-19 -- including variants of concern," Dr. Natasha Bagdasarian, Michigan's chief medical executive, said in a statement this week.

Peters said he has been encouraged by the continued increase in vaccinations in the state, including among newly eligible pediatric populations, but "those numbers aren't growing rapidly enough."

"[Omicron] is yet another reason for the public to get vaccinated now without waiting any longer," he said. "I fear that there are so many Michiganders, and I'm sure it's true outside of Michigan as well, but who believe that the pandemic is largely over. And nothing could be further from the truth."

ABC News' Arielle Mitropoulos contributed to this report.

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How your ZIP code determines your lung health

Darren Riley, 29, is the CEO and Co-founder of JustAir, which uses small sensors to map air quality on a neighborhood level. - JP Keenen/ABC News

(NEW YORK) -- This is the fourth and final episode of ABC News Digital's four-part series "Green New Future," which highlights innovators and environmental solutions.

While climate change and poor air quality are global issues concerning all people, 29-year-old Darren Riley has found that the ZIP code people are born into can disproportionately put them in harm's way.

Riley's father ended up in a coma in the ICU due to asthma-related illnesses in 2014, Riley told ABC News. It was his father's words from seven years before that made him realize the connection between a person and where they live.

"I was a product of my environment," Riley's father had told him.

Riley, who also developed asthma himself, said he set out to find a way to alleviate systemic issues and allow people from all areas an equal opportunity in quality of life. He is now the CEO and co-founder of JustAir Solutions, a company that creates air quality monitoring networks to provide cities and individuals data on their breathing environment.

"I think air quality is a sliver of all of many injustices that we see in the world that we can really focus on," Riley told ABC News.

The disproportionate impact of pollution is one example of a host of systemic issues that people of color, lower wealth communities and indigenous populations are facing, advocates say.

These issues are "fueled by environmental racism," Mustafa Ali, vice president of environmental justice, climate and community revitalization at the National Wildlife Federation, told ABC News.

Through discriminatory practices such as redlining, cities in the U.S. have been divided and designed with toxic industries disproportionately running through areas inhabited by communities of color, according to Ali.

This affects the quality of the air people breathe, which research has found can determine the long-term health of their lungs and subsequently, their life expectancy.

"We have 100,000 people who die prematurely from air pollution in our country," Ali said.

This issue came to the forefront over 50 years ago when Congress passed the Clean Air Act, which set out to control and reduce air pollution across the nation by keeping track of the quality of air that citizens were inhaling.

The U.S Environmental Protection Agency mandates that cities track their air quality levels using a monitor that tracks dust, metals and other matter that could affect the lungs.

The EPA regulations state there must be a minimum of one monitor per city, but community advocates argue there must be more. Grand Rapids, Michigan, where Riley piloted his project, has just one monitor that reports on the city's air quality level.

Data from that monitor is used to approximate the air quality level for the entire city and its suburbs, Jim Meeks, the chairman of JustAir, told ABC News.

But Riley was curious about the difference in air quality levels across neighborhoods, which the lone monitor set up by the EPA could not capture. He deployed 11 sensors across Grands Rapids -- five in the downtown area, five in the Roosevelt Park neighborhood and one adjacent to the EPA monitor.

When comparing data from his sensors in the metro downtown area of Grand Rapids versus Roosevelt Park, the neighborhood with the highest non-white population, Riley found stark differences in the air quality levels.

The Roosevelt Park sensors recorded far more unhealthy days than the one near the EPA monitor, Riley said.

"There are disparities between sensors within a city," Riley told ABC News. "And one sensor doesn't detect that."

JustAir's sensors are currently only used in Grand Rapids, but Riley hopes to expand his company to other cities such as Detroit and Chicago, believing that the data could inform governments and individuals to take action.

He said he hopes his company will bring change to the nation's struggle with poor air quality and its health impacts.

The key to fighting air pollution-related health disparities lies in the re-prioritization of resources and budgets and breaking through the existing political polarization, according to Ronda Chapman, equity director at The Trust for Public Land.

"This is a non-partisan concern when we're talking about the health and well-being of individuals," Chapman told ABC News. "And so when we have the data to back it up, that's how we're able to better make the case for investing in green infrastructure, investing in neighborhoods and investing in communities."

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Strangers donate breast milk after mom of newborn dies of COVID-19

Courtesy Brittany Eppenauer

(OAK GROVE, Mo.) -- Megan Richards, a mom of six, had planned to provide breast milk for her youngest child, 5-month-old Myles, through his first birthday.

Richards died last month due to complications from COVID-19, and now her family is trying to fulfill her wish by collecting donations of breast milk.

"It was one of the things that she wanted the most for the baby, and it was important to her, so it was important to me," said Megan's husband, Michael Richards. "Even when she got sick and I was trying to keep her in bed, and just try to get her to rest, I talked to her about it maybe being time to stop pumping -- she'd been pumping to be able to feed him with a bottle -- and she refused."

The Oak Grove, Missouri, family has so far received about 400 ounces of donated breast milk, as well as a donated freezer to store it.

They estimate they will need around 10,000 ounces to reach Myles's first birthday next July, according to Brittany Eppenauer, Megan Richards's sister.

Eppenauer is leading the drive for breast milk donations and said she's received nearly 300 emails from women who want to donate.

"The first donation that we received came from a woman named Megan," she said. "It's overwhelming to know that other moms care that much, to make sure that we can fulfill my sister's wishes."

Megan Richards was 32 when she died Nov. 15. She was the mother of five biological children and shared a step-child with her husband, with whom she would have celebrated her second wedding anniversary on Nov. 30.

"She was a perfect mother. Everything she did was for the kids," Michael Richards said of his late wife. "We put off vacations and dates for ourselves so we could spend more time with the kids. Everything was about them."

Michael Richards said he and his wife and all six children contracted COVID-19 in mid-November, with most of them suffering only mild symptoms.

Myles had to be treated at the hospital for dehydration, but recovered quickly. Megan Richards, who was not vaccinated against COVID, began suffering worsening symptoms and had to be taken to the hospital by ambulance on Nov. 14, according to Michael Richards.

"I stepped outside to call 911, and when I got back inside Megan was laying on the living room floor," he said. "Our oldest said she stood up and said she didn't feel right and passed out."

At the hospital, she was treated for dehydration and diagnosed with COVID pneumonia, but was expected to recover quickly, according to Michael Richards.

The next day, he said he received a call from the hospital that his wife's condition had worsened. When Michael Richards arrived at the hospital, doctors were performing CPR on Megan, who had fluid buildup around her heart. She died later that day.

Both Michael Richards and Eppenauer said they're now trying to fill the void left by Megan Richards, described by Eppenauer as "one of the best mommas around."

"My niece's birthday was on Dec. 1st, and it took eight adults to do what she could have done as one person in putting on a birthday party," Eppenauer said. "We don't know how we'll fill her shoes, but we're going to try."

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Amid spread of omicron variant, CDC expected to require negative COVID-19 test 1 day before flying to US


(WASHINGTON) -- The Biden administration is preparing to implement new travel guidelines that would require proof of a negative COVID-19 test within one day of flying into the U.S., including for vaccinated people, a spokesperson from the Centers for Disease Control and Prevention confirmed.

The expected change comes as the country beefs up surveillance for the omicron variant, the first case of which in the U.S. has been identified in California, the California and San Francisco Departments of Public Health said Wednesday. The CDC said the person traveled from South Africa on Nov. 22.

Omicron has been deemed a "variant of concern" by the World Health Organization and had been detected in over 20 countries as of Tuesday.

"CDC is working to modify the current global testing order for travel as we learn more about the omicron variant; a revised order would shorten the timeline for required testing for all international air travelers to one day before departure to the United States," CDC spokesperson Kristen Nordlund said Tuesday night. "This strengthens already robust protocols in place for international travel, including requirements for foreign travelers to be fully vaccinated."

Under the current guidelines, people from other countries who are not fully vaccinated cannot travel to the U.S., while people who are fully vaccinated can as long as they provide proof of a negative COVID-19 test within three days of traveling. For unvaccinated Americans, the guidelines already required proof of a negative test within one day of traveling. The potential new rule would expand that one-day requirement to all vaccinated travelers coming into the U.S. from other countries.

For post-travel recommendations, the CDC also suggests vaccinated travelers get tested three to five days after arriving in the U.S. and that unvaccinated travelers stay home to self-quarantine for a full seven days, even if they test negative during that timeframe.

Earlier on Tuesday, the White House confirmed it was considering updates around testing requirements and said policy discussions were ongoing across the government as more is learned about the omicron variant.

More updates on the country's response to the variant are expected Thursday.

CDC Director Rochelle Walensky outlined some of the expected changes at the White House COVID-19 briefing on Tuesday morning. She said the CDC is analyzing 80,000 COVID-positive tests per week -- or about one in seven tests -- looking for the omicron variant. The delta variant continues to account for 99.9% of all tests analyzed, Walensky said.

Asked if she was confident in the CDC's surveillance system given how many other countries had detected the variant before the U.S., Walensky said the system is "robust."

The director also said the CDC is working on expanding a surveillance program in the nation's four busiest international airports, John F. Kennedy International Airport, San Francisco International Airport, Newark Liberty International Airport and Hartsfield-Jackson Atlanta International Airport, which would allow for more COVID-19 tests on international arrivals -- though there was no indication that testing would be mandatory for arriving travelers or which arriving planes would be offered the tests.

In the meantime, experts are calling on all Americans to get vaccinated if they haven't yet and to get boosted if they're over 18 and were fully vaccinated over six months ago. Of those eligible for a booster, 100 million Americans haven't gotten one yet, the White House said on Tuesday, while just about 20% of fully vaccinated Americans have, the CDC's vaccine data shows.

Though the data on how transmissible and severe the omicron variant is will not be available for a few more weeks, as scientists around the globe work to gather it, experts believe it's unlikely it will completely chip away at the protection from vaccines and boosters, particularly when it comes to hospitalization and death.

"Remember, as with other variants, although partial immune escape may occur, vaccines and particularly boosters give a level of antibody that even with variants like delta, give you a degree of protection, particularly against severe disease," Dr. Anthony Fauci, chief medical adviser to the White House, said on Tuesday.

On Tuesday, Pfizer BioNTech asked the Food and Drug Administration to consider expanding the booster recommendation to include 16- and 17-year-olds. The agency is expected to review the request in the coming weeks.

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What to know about new COVID-19 variant omicron


(NEW YORK) -- Global health authorities said they're monitoring a new COVID-19 variant first identified in southern Africa, with the World Health Organization saying Friday the new strain, called omicron, is a variant of concern.

On Monday, the WHO said the overall global risk is assessed as "very high" due to the variant's mutations although there are still many unknowns.

The WHO urged countries to step up monitoring and surveillance. The global health agency said it's still not clear whether the variant is more transmissible or causes more serious illness, or if it affects vaccines. Such studies will take time.

The first confirmed case in the U.S. was identified in California on Wednesday in a vaccinated individual, but the person's symptoms were mild, the U.S. Centers for Disease Control and Prevention said. The person had traveled to South Africa in late November.

"As all of you know -- because we've been discussing this -- we knew that it was just a matter of time before the first case of omicron would be detected in the United States," Dr. Anthony Fauci, the White House's chief medical adviser, said Wednesday.

As of Wednesday, there were more than 370 confirmed cases in nearly 30 countries across the globe, with most in South Africa but seven cases in Canada and a few dozen in the U.K.

"We don't know very much about this yet," Dr. Maria Van Kerkhove, the WHO's COVID-19 technical lead, said Nov. 25. But concern about this variant stems from its "large number of mutations," Kerkhove added, which could "have an impact on how the virus behaves."

Concerns about this variant already have prompted several countries, including the U.S., to impose travel restrictions from countries in southern Africa. The WHO is urging calm, saying it's premature to close borders.

There are thousands of COVID-19 variants, with new ones emerging all the time. Usually new variants disappear quickly because they're overrun by a more dominant strain.

The now-dominant delta variant is so highly transmissible that most of the new variants that have cropped up in recent months have been unable to gain a foothold. In the United States, the delta variant comprises an estimated 99.9% of all new cases.

"There's obviously this tension between crying wolf and exacerbating concerns about the variants, but also being caught flat-footed and not responding swiftly enough," said Dr. John Brownstein, chief innovation office at Boston Children's Hospital and an ABC News contributor. "This is where we have to cautiously respond without inciting panic, because this could easily turn out to be a variant similar to others that have never really panned out to be global concerns."

Scientists across the globe constantly monitor all newly emerged variants to see if they're spreading in a meaningful way and global health authorities have said they're monitoring this new variant closely.

Vaccine companies, meanwhile, are making plans to tweak vaccines to address new variants if it becomes necessary.

Current COVID-19 vaccines, which rely on genetic technology, could be easily updated to better combat emerging variants -- though so far that hasn't been necessary.

Pfizer/BioNtech said that if a "vaccine-escape variant emerges," it expects "to be able to develop and produce a tailor-made vaccine against that variant in approximately 100 days, subject to regulatory approval."

Moderna also said it is "rapidly advancing" an omicron-specific variant, while Johnson & Johnson also said it will move forward with an omicron-specific vaccine as needed.

Nine variants are currently being monitored by the WHO, which designates particularly worrisome strains as variants of "interest" or "concern." When they no longer pose a significant public health threat, the variants are reclassified -- so far during the pandemic, 13 have been removed from the WHO's list.

But public health experts said the emergence of variants underscores the urgent need to vaccinate everyone on the planet.

"It gives us a lens into why as epidemiologists we've been so concerned about global vaccine equity," Brownstein added. "It's a recognition that with not enough people around the globe immunized, it creates more opportunities for variants to emerge, and this is a very good example of that."

ABC News' Guy Davies, Josh Hoyos, Aicha El Hammar, Zoe Chevalier, Liezl Thom and Zoe Magee contributed to this report.

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