nevodka/iStockBy SASHA PEZENIK, ABC News
(NEW YORK) -- With the steady march toward a safe, effective and authorized coronavirus vaccine, another race now runs alongside: how to dispatch tens of millions of doses across every corner of the nation and globe, and do it safely, securely and swiftly. The solution will involve complicated logistical calculus, experts say, no matter which vaccine gets across the finish line first.
Pfizer's vaccine is likely to be the first to be granted authorization by the Food and Drug Administration, followed by one created by Moderna, and then possibly vaccines from AstraZeneca/Oxford and Johnson & Johnson, if the efficacy and safety data prove solid.
The U.S. government has promised a goal of "shots in arms" within 24 hours of FDA authorization of the first COVID-19 vaccine.
All about the money
Those responsible for the cross-country relay -- state and local public health officials and supply chain experts -- have hustled to marshal their resources, even as shortage concerns linger and officials warn the federal dollars they have received so far will not be enough.
"There's a light at the end, but that tunnel is still very long," Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, told ABC News. "We at the state level will soon be handed the baton and we need additional funding support from the federal government. What's at stake is nothing short of the velocity and equity with which we can get this vaccine to everyone in need."
More than a dozen states have told ABC News they will likely need additional funding, or are awaiting additional funding. In response to concerns raised by the National Governors Association, Operation Warp Speed has said it is in the process of planning to make additional funding and resources available to support vaccine operations, information systems and communications campaigns, though some officials still say more will be needed.
"Without those additional resources, it will be like putting up tent poles without having a tent," Shah said. "We've got to think through literally everything, from when the vaccine enters our borders to the time it goes into somebody's arm for injection."
That "last mile" of distribution may pose the rockiest stretch of the journey, experts say. Getting the vaccine from a central transportation hub to its final destination at local hospitals and pharmacies across the country will require unprecedented coordination and delicately calibrated conditions.
The U.S. government estimates having 40 million doses -- enough for 20 million Americans -- by the end of this year if the FDA provides authorization in early December. About half of those vaccine doses will be provided by Pfizer, with the other half by Moderna.
Pfizer's vaccine must be stored at temperatures colder than Antarctica in winter: roughly minus 94 degrees Fahrenheit. Doses would ship in dry ice thermal containers, stored either with replenished dry ice for up to roughly two weeks or stored in ultra-low temperature freezers. Moderna's vaccine also requires cold storage, though not as extreme: It can be stored around minus 4 degrees, the same as a commercial freezer.
Manufacturers, logistics providers, federal and state governments and health care systems have been shoring up their cold chain infrastructure for months, lining up equipment and transportation capacity.
"The clock starts ticking once those dry ice containers start shipping around," Dr. Mark Jarrett, chief quality officer of Northwell Health, New York's largest health system, told ABC News.
The Centers for Disease Control and Prevention told states and localities not to buy ultra-cold freezers for now, since the Pfizer vaccine will be shipped with dry ice "pizza boxes" that can keep it viable for up to 15 days, as long as there's fresh dry ice available. It can then last five additional days in a conventional freezer.
Dry ice faced "significant shortages" during the pandemic's spring surge, President and CEO of the Compressed Gas Association Rich Gottwald told ABC, warning in an April letter to Vice President Mike Pence.
In mid-October, the nation's governors penned a letter to the Trump administration with several concerns, including ultra-cold freezer and dry ice supply, and seeking clarity so that "no one is caught flat-footed when the time comes to vaccinate people."
The Compressed Gas Association now says they expect "sufficient" dry ice supply for COVID-19 vaccines.
"There may be issues with [the] COVID vaccine; the supply of dry ice will not be one of those issues," Gottwald said.
Still, some dry ice manufacturers and distributors are echoing those earlier warnings.
"Our system is already taxed beyond what the supply is right now," Tim Koerner, co-owner of the American Carbonation Corporation, told ABC News. "It could be close to sufficient, but it's gonna be tight."
UPS announced Wednesday it's ramping up dry ice production capabilities and launching a mobile freezer storage unit supply, noting "a major spike in demand" and the need to "plan for what some analysts fear may be a dry ice shortage" amid vaccine preparation.
Public health authorities and hospitals who can afford the investment are acquiring ultra-cold freezers, despite CDC guidance, to maintain supply chain agility.
Unsure how much vaccine they'll be receiving, David Reich, president of The Mount Sinai Hospital and Mount Sinai Queens, said they had bought a number of the freezers to be ready for whatever comes.
Henry Ford Health System in Michigan announced Wednesday it had received and begun installing six specialized freezers for the Pfizer vaccine, and six other freezers for the Moderna vaccine.
Distributing the vaccine
UPS Healthcare is collaborating with Stirling Ultracold, an Ohio company making laboratory-grade ultra-cold freezers, to supply portable models for storage of vaccines.
Demand has "dramatically increased," Stirling Ultracold CEO Dusty Tenney told ABC News. Sales are up 250% since the first quarter, with backorder times up to six weeks.
"There is a lot riding on everyone right now to make sure this is successful," Tenney said.
An onboard computer tracks temperature through the cold chain's many handoffs "to ensure that when they do arrive, there's no waste or loss associated with the vaccine's efficacy," Tenney said.
"Our job is to make sure nowhere in that process does it break down," Tenney added.
Stirling Ultracold hopes to have 2,000 portable freezer units in use by January. Each portable unit can hold 6,000 doses, allowing for 12 million of them throughout the country at a time.
"We were concerned about the freezers, and so we quickly purchased and pre-positioned them at certain sites along the health system," Jarrett, from Northwell Health, said. "That's one thing we've learned in COVID -- was try and be ahead of the curve."
Those freezers don't come cheap: each unit, depending on the model, ranges from $6,000 to more than $10,000.
"You can't strap [vaccine] on the back of 'Bob's truck,'" Shah said.
Maine has received $800,000 in federal funding so far, and "significantly more will be needed," as they ramp up logistics and manpower.
Dry ice also has flight restrictions, which could further hamper distribution.
Who gets the vaccine and when?
Not all the vaccine candidates share the need for shipping in extreme temperatures. In addition to Moderna's, which can be held in most standard freezers, the vaccines from AstraZeneca/Oxford and Johnson & Johnson don't need to be frozen at all and can be safely stored for months in a standard refrigerator.
But all vaccine shipments will face logistical problems for one reason or another.
"We need to address the fact that all last miles in this country are not equal. If logistics work against our most-vulnerable populations, we will further exacerbate the impact of this pandemic," said Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News Contributor.
"We've already seen the incredible divide when it came to testing -- increased travel times for counties with lower population density and higher percent of minority and uninsured. Will the challenges of cold storage and the requirement for two doses further exacerbate health inequities when it comes to immunizations?" Brownstein continued. "We'll need further analysis to understand how these logistical challenges intersect with fair and equitable access."
"We have to be ready for all of it," said Dr. Abinash Virk, infectious disease specialist at the Mayo Clinic. "It's a complicated process now happening at supersonic speed."
Figuring out which front-line staff has priority for the injection's first wave, organizing electronic medical systems and data communication must be done before the first shot and before knowing which vaccine will be the one they're giving, Virk said.
"Pfizer has the most restrictive storage and transport requirements," Virk said. "If we're able to handle that, then, the subsequent ones, hopefully, will be able to handle much easier."
Vaccines requiring two doses offer their own unique coordination: Pfizer's needs a booster after 21 days while Moderna's requires one after 28 days. That means ensuring the right shipment arrives in time for the patient who needs their second dose.
That could get harder in remote areas.
"All this will be unfolding as the vaccine is literally rolling in trucks to get there," Dr. Robert O. Williams III, of the University of Texas at Austin's Division of Molecular Pharmaceutics and Drug Delivery, said. "For rural areas that don't have the same infrastructure and cold infrastructure, that's an added challenge."
"We're the last mile. And that's sometimes the toughest mile," Jarrett said. "And there may be hurdles, but that's never going to stop us from doing the right thing."
Copyright © 2020, ABC Audio. All rights reserved.
tuachanwatthana/iStockBy IVAN PEREIRA and CAMMERON PARRISH, ABC News
(LOS ANGELES) -- Los Angeles County is on the brink of ordering new restrictions to combat the rising coronavirus cases, but the latest proposal made by the Health Department won't bring the area to a complete lockdown.
Health officials presented their recommendations for a future stay-at-home order during a meeting with county supervisors Tuesday, though the LA County Board of Supervisors has not moved forward with the "Safer at Home" order as of Wednesday afternoon.
The county set a threshold of a five-day case average of 4,500 or higher for a stay-at-home order to go into effect. On Monday, the county surpassed that threshold, but on Tuesday, the average was around 4,200, according to the Health Department.
LA County health officials said a new "Safer at Home" order would not be as restrictive as the one issued in March that closed schools and barred travel outside a household, except for groceries.
Their new recommendations include a ban of all public and private gatherings involving people not in the same household, except for outdoor church services and outdoor protests, and a 50% capacity requirement at outdoor retail stores.
The Health Department also recommended a 35% capacity for essential indoor businesses and a 20% capacity for non-essential indoor businesses. Under the recommended order, shoppers, employees and people who attend permitted gatherings would be required to wear face masks, according to the Health Department.
Outdoor parks, beaches and trails will remain open, and outdoor recreation will be permitted as long as residents practice social distancing and wear a mask, the department said.
"I know for sure we're not going back to all of the restrictions that were in place in the original Safer At Home order,'' LA County Public Health Director Barbara Ferrer told reporters during a conference call Tuesday.
The Health Department recommendations come as both LA and California continue to see spikes in cases and pressure on its health care providers. On Wednesday, Los Angeles reported 4,311 new cases and 49 new deaths.
Los Angeles County surpassed the county that encompasses Brooklyn, New York, as the county with the most COVID-19 fatalities in the country, with 7,543 total deaths, according to the Health Department and John Hopkins University’s Coronavirus Resource Center.
Health officials said Wednesday during a virtual news conference that one out of every 145 Los Angeles County residents is currently infectious, and they are expecting shortages in hospital beds, including ICU beds, in the next two to four weeks.
Dr. Christina Ghaly, the director of the Los Angeles County Department of Health Services, said there will likely be a doubling of cases every two weeks, possibly even tripling.
Despite holding off on a full stay-at-home order, county supervisors have proceeded with a plan to prohibit in-person dining. Eateries and bars will be able to offer take-out options, but they cannot serve customers either indoors or outdoors for the next three weeks, according to the order.
“From Oct. 31 to Nov. 14, outbreaks at food facilities have increased by 200%," Dr. Muntu Davis, the LA County Public Health Officer, said during the news conference.
County business leaders, including the Chambers of Commerce for West Hollywood and Culver City, also held a news conference Wednesday to denounce the move. They warned they may have to make tough decisions.
"On the eve of the Thanksgiving holiday, our businesses may have to lay off hundreds, if not collectively thousands of employees," Genevieve Morrill, president and CEO of the West Hollywood Chamber of Commerce, said.
The business leaders called on the county and state to consider long-term solutions that would not harm their operations and asked for a COVID-19 emergency business interruption fund to offset their losses.
"Just checking the boxes off to show the public that you’re doing something is not enough," Morrill said.
Copyright © 2020, ABC Audio. All rights reserved.
zoranm/iStockBy KATIE KINDELAN, ABC News
(NEW YORK) -- Scotland made history this week, becoming the first country in the world to provide period products to all women for free.
The Period Products (Free Provision) Scotland Bill was passed unanimously by the Scottish Parliament on Tuesday.
Its passage means the government will now set up a nationwide program to "allow anyone who needs period products to get them free of charge." Schools, colleges and universities also must make period products available for free in bathrooms and the Scottish Government will now have the power to "make other public bodies provide period products for free," according to the legislation.
Nicola Sturgeon, Scotland's first minister, wrote on Twitter after the bill passed that she was "proud to vote for this groundbreaking legislation," which she heralded as an "important policy for women and girls."
Proud to vote for this groundbreaking legislation, making Scotland the first country in the world to provide free period products for all who need them. An important policy for women and girls. Well done to @MonicaLennon7 @ClydesdAileen and all who worked to make it happen https://t.co/4lckZ4ZYIY
— Nicola Sturgeon (@NicolaSturgeon) November 24, 2020
Scotland began offering sanitary products for free in schools, colleges and universities two years ago.
Monica Lennon, sponsor of the Period Products (Free Provision) Scotland Bill, has said that her goal was to make offering free sanitary products a legal requirement.
"A proud day for Scotland and a signal to the world that free universal access to period products can be achieved," Lennon wrote on Twitter after the bill passed.
Thank you to everyone who has campaigned for period dignity and to my MSP colleagues for backing the Bill tonight.
— Monica Lennon (@MonicaLennon7) November 24, 2020
A proud day for Scotland and a signal to the world that free universal access to period products can be achieved. #freeperiodproducts 🏴 https://t.co/NC3e97jPuQ
Period poverty, when people cannot afford even the most basic of period supplies like pads and tampons, is an issue that affects women around the world.
At least half a billion women and girls globally lack facilities for managing their periods, according to a 2015 report from the World Health Organization and UNICEF.
In the United Kingdom, the lockdown due to the coronavirus pandemic has exacerbated period poverty, with 3 in 10 girls there struggling to afford or access products, according to a report released in May by Plan International, a girls' rights organization.
In the U.S., where women make up more than half of the population, women are more likely than men to live in poverty, and they spend an average of 2,535 days in their lifetime, or almost seven years, on their periods, according to UNICEF.
A survey released last year of low-income women in St. Louis found that nearly two-thirds couldn't afford menstrual hygiene products in the past year, and more than 1 in 5 said they had the same problem every month. The women said they instead had to use cloth, rags, tissues, toilet paper and sometimes diapers or paper towels, according to the report published in Obstetrics & Gynecology.
Poor menstrual hygiene poses health risks for women, including reproductive issues and urinary tract infections.
The taboo around menstruation and the lack of access to menstrual products also hurts women economically because it costs them money for products and may keep them from jobs and school, advocates say. It also sets women back mentally and in a society where something that happens to them naturally is demeaned or even not discussed.
"Most of us have been conditioned for all of our lives to not talk about menstruation," said Jennifer Weiss-Wolf, a lawyer and author of "Periods Gone Public," told Good Morning America last year. "And the things that keep us potentially from succeeding are often the things that happen to be what we don't talk about in polite society."
Copyright © 2020, ABC Audio. All rights reserved.
izusek/iStockBy ARIELLE MITROPOULOS, ABC News
(NEW YORK) -- As Americans prepare for what will likely be an untraditional Thanksgiving, health experts and state officials are pleading with the public to heed their warnings to not travel and to avoid large gatherings and the mixing of households, as the country tries to get a hold on what experts call an "uncontrolled" spread of the coronavirus.
"If we layer in travel and large indoor gatherings which we know are drivers of transmission, we expect to see a massive surge on top of an already dire situation," said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital and an ABC News contributor, warning that such a surge could result in a "humanitarian crisis."
Holidays have proven to be a catalyst of COVID-19 spread across the country. Earlier this year, after each summer holiday, the U.S. reported a significant uptick in infection across the country, and experts say Thanksgiving could have all the components of a potentially deadly event.
Prior to Memorial Day in May, the national seven-day average of new cases was hovering around 21,000 new cases a day. Five weeks later, that average had doubled, according to an ABC analysis of data compiled by the COVID Tracking Project.
A similar pattern occurred just over a month later following the Fourth of July weekend. Less than three weeks after Independence Day, the average number of new cases had risen by almost 40%, with nearly 60,000 patients hospitalized.
And after the summer surge began to decline, it was shortly after Labor Day that new cases began to rise again, bringing the country to its latest surge. As the weather got cooler, public health experts who had long warned against large gatherings began sounding the alarm that even small gatherings -- particularly those that are indoors, with poor ventilation -- could drive COVID-19 transmission.
Since mid-September, the number of daily coronavirus cases has increased by nearly 400%, and now the virus is significantly more widespread than it ever was during the summer.
The national average of daily new cases is now more than 100,000 higher than it was in July and five times higher than it was during the initial peak in April.
In the month of November alone, the U.S. has reported nearly over 3.2 million COVID-19 cases, making it by far the worst month on record for daily cases, with a quarter of the country's total cases.
Cases are rising in all but one state, Hawaii, while current hospitalizations are increasing in 48 states, Washington, D.C., and Puerto Rico.
Daily deaths in the U.S. are up by more than 30% from just last week, with 10,617 deaths recorded over the last seven days -- a rate of approximately one death reported every minute.
In preparation for the potential fallout, the Centers for Disease Control and Prevention released new guidance last week that strongly recommended postponing travel and staying home this year as "the best way to protect yourself and others."
"Celebrating virtually or with the people you live with is the safest choice this Thanksgiving," the CDC said.
Dr. Anthony Fauci, the nation's top infectious disease expert, has been taking to the airwaves, repeatedly advising Americans to limit Thanksgiving gatherings to members of the same household.
"The travel, the congregate setting, not wearing masks -- the chances are that you will see a surge superimposed upon a surge," Fauci warned. "What we're doing now is going to be reflected two, three weeks from now."
This message, to please stay home, has been echoed by governors and local officials across the country.
"We don't really want to see mama at Thanksgiving and bury her by Christmas," Mississippi State Medical Association President Dr. Mark Horne said during a virtual meeting last week.
"This year, if you love someone, it is smarter and better to stay away -- as hard as that is to say and hear," said New York Gov. Andrew Cuomo in a press release. "Because if I had to predict, you're going to see a significant spike post-Thanksgiving."
Massachusetts Gov. Charlie Baker is also advising residents to only gather with members of their own household.
"We are urging everyone to make a difficult choice this Thanksgiving," Baker said during a press conference last week. "We saw what happened in Canada when they had their Thanksgiving in October."
And seven Midwestern governors -- five Democrats and two Republicans -- joined forces in a video and opinion piece in the Washington Post to deliver a bipartisan message urging precautions during the upcoming holiday.
"Think about your last Thanksgiving and the people you were surrounded by," they said. "Picture their faces -- laughing with you, watching football with you or even arguing with you about politics. As hard as it will be to not see them this Thanksgiving, imagine how much harder it would be if their chairs are empty next year."
"We must make short-term sacrifices for our long-term health," the video concluded.
Despite the warnings, millions are still traveling this holiday, with the Transportation Security Administration this past Sunday screening over one million people for only the second time since the start of the pandemic.
And while the role of indoor gatherings in viral transmission cannot be fully quantified, experts stress that they greatly contribute to the spread of COVID-19.
"These gatherings are in conditions with poor adherence to social distancing and masking along with suboptimal ventilation," Brownstein said.
Experts also say that travelers getting tested before they head home does not mean they're protected.
"The confusion around testing also means that many false negatives will give an unwarranted sense of security to those asymptomatic cases or cases during the presymptomatic phase," Brownstein said, adding that "because of this significant countrywide population mixing, we expect hospitalizations will cross 100,000 and deaths to approach 300,000 by the end of the year."
But ultimately, for millions of Americans, these COVID-19 numbers are much more than just statistics; they represent family members and friends lost to the virus, who will be missing this holiday.
"I can understand the humans behind those numbers," Brandie Kopsas-Kingsley, an ICU Nurse from IU Health Indianapolis, Indiana, told ABC News. "Every single one of those was a life, and a person that mattered. As we celebrate Thanksgiving, that is an empty chair. And all of us have a great responsibility to quarantine, to stay safe, to not go see others."
Copyright © 2020, ABC Audio. All rights reserved.
Toa55/iStockBy RAMIE FATHY, ABC News
(NEW YORK) -- With the COVID-19 pandemic dominating the headlines, President-elect Joe Biden has just released his administration's plan to address another potentially catastrophic global threat: climate change.
Scientists warn that it's not just plants and animals threatened by rising temperatures -- climate change is impacting humans as well. And for medical experts, this is particularly troubling.
"We're in it now," said Dr. Paul Auerbach, an emergency medicine physician at Stanford University and author of Enviromedics, the pioneering book on climate change and health. "It's happening, and it all boils down to health. This is a health care issue."
Though the effects of climate change on health are numerous, they remain unfamiliar to many. Climate change has now been linked to heat-related illnesses, the spread of infectious disease, physical harm from extreme weather, health complications related to poor air quality, and other individual and public health harms.
Perhaps most importantly, climate change could become one of the main drivers of future novel outbreaks, and may have contributed to the current COVID-19 pandemic.
"The next global pandemic could be, in some capacity, due to climate change," said Dr. Jesse Bell, professor of Health and Environment at the University of Nebraska Medical Center College of Public Health.
ABC News spoke with a variety of health experts to determine the top five ways climate change is affecting human health.
As the planet gets warmer, people across the globe are beginning to feel the heat.
"Right now, the clearest effects of climate change are through heat," said Dr. Aaron Bernstein, a pediatrician and interim director of the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health.
"More people die each year from heat -- more than from many medical problems," Bernstein said, noting that heat waves may aggravate a wide range of illnesses, from asthma to mental health disorder to diabetes and kidney disease.
So dire is the threat to human health that Bernstein helped compile guidelines for educating medical trainees about the health effects of climate change.
"Heat waves likely kill more people in the U.S. than any other climate-related disaster, because heat waves occur everywhere across the U.S., including places as different and distant as Nebraska, Los Angeles, New York City, and Seattle," said Bell.
As anyone who has eaten leftovers that have been left out too long can attest, infectious agents -- and the bugs that carry them -- thrive in particular environments and conditions. And as climate change alters environmental conditions across the planet, so too does it affect the geographic distribution of infectious diseases.
"Some infectious diseases that were already present in North America, like Lyme disease, leishmaniasis, and various fungal infections, have already become an issue in areas that were previously unaffected by them," said Dr. Misha Rosenbach, a dermatologist and climate change activist at the University of Pennsylvania.
According to the Centers for Disease Control and Prevention, the number of Lyme cases in the U.S. has more than tripled since 1995, and rates continue to rise.
Meanwhile, climate change has also facilitated the spread of waterborne infectious diseases.
"Warmer temperatures around the globe cause rising sea levels, warmer seawater, and either more frequent or increasingly severe natural disasters like hurricanes and floods," said Rosenbach. "And each of these events is associated with a range of infectious diseases, including life-threatening diarrheal disease, respiratory infections, and skin infections."
Natural disasters, such as recent hurricanes Harvey and Sandy, brought diseases like cholera and bacterial infections in their wake, according to Dr. Saul Hymes, an assistant professor of clinical pediatrics and a specialist in pediatric infectious diseases at Stony Brook Children's Hospital.
Climate change is also a driving force behind "spillover" events, in which viruses leap from their animal hosts into humans, Hymes said.
"Climate change causes disruption to natural animal habitats, and also movement of people into new habitats to avoid flood regions or drought-prone areas," Hymes said. "This can bring humans and animals into more contact and lead to increased likelihood of disease crossover events like those we are seeing more often, including SARS-CoV-2."
Extreme weather events
Along with the ongoing pandemic, 2020 has also witnessed a record-breaking hurricane season as well as wildfires and floods across the globe -- and climate change is thought to be contributing to the severity of all of these extreme weather events.
Experts predict that these are not outlier events but rather the start of a new normal.
"These trends will likely continue over the next century," Bell said.
And extreme weather events have indirect health impacts by creating refugee areas.
"As with the Astrodome in Houston after Katrina, these can become overcrowded and thus are hotbeds for transmission of flu and other common person-to-person viral infections," Hymes said.
Another way climate change affects human health is through its impact on air quality. While the burning of fossil fuels directly pollutes the air, global warming that's a byproduct of fossil fuel combustion also contributes to and exacerbates worsening air quality.
"For one, climate change has led to drought and to heat waves that have caused the California wildfires, and the smoke and particulates in the air directly harms those with respiratory issues like COPD or asthma," Hymes said.
Even without wildfires, rapid temperature swings and ozone depletion can exacerbate respiratory illnesses like asthma, according to Hymes. Meanwhile, climate change can influence air quality and human disease through an intermediary: plants.
"Warmer climate and longer summers have led to alterations in pollination and flowering cycles -- some plants now undergo a second flowering in a season, for example," said Hymes. "In general, there's been either a significant increase in pollen counts or a major shift in their timing, or both. And these are often significant asthma triggers as well as affecting other allergic conditions."
Mental health and trauma
According to Bell, extreme weather events can spur mental distress.
"The psychosocial impact of extreme weather events is huge," he said. "People have their possessions and homes destroyed. They must move and rebuild and often are doing so with much of their wealth obliterated. This can cause significant mental distress, rates of depression and anxiety, as well as PTSD rise in survivors of such events."
Some researchers have already begun documenting the psychological impacts of climate change, including major depression, anxiety, PTSD and adjustment disorders, as well as increases in drug and alcohol use and domestic violence. The chronic stress caused by climate disasters has also been associated with worse cardiovascular health.
"It is absolutely imperative that we address these psychological issues because they have impacts on everything: personally, socially, economically, politically," said Dr. Lise van Susteren, a psychiatrist and environmental activist.
But to van Susteren, climate change's effects on mental health extend far beyond the individual level.
"Injuries, deaths, houses being burned down or flood, the loss of possessions and general disruption of life -- these all have a psychological toll," van Susteren said. "In turn, all of these psychological damages have an impact on our physical health, and this has repercussions on all aspects of our lives."
Though climate change has already begun to impact our health and well-being, scientists and doctors say it's not too late to take action to combat it and to mitigate its effects -- through personal choices to reduce your carbon footprint, through community action, and through smart policy.
"Realize that everything you do is part of the collective, and realize that you're setting the social norm," said van Susteren. "It all begins at home."
Copyright © 2020, ABC Audio. All rights reserved.
bhofack2/iStockBy KATIE KINDELAN, ABC News
(NEW YORK) -- As Americans are urged to stay home and celebrate Thanksgiving either alone or only with people in their household to help stop the spread of COVID-19, it's clear the holiday, normally a time of gathering, is going to look a lot different this year.
On Pinterest, searches for "Thanksgiving for one" are up nearly 70% this year, according to the social sharing site. Zoom, a video communications company, announced it will waive its 40-minute time limit on free accounts on Thanksgiving Day to help families stay in touch.
While some people may be home alone on Thanksgiving by choice, following safety guidelines, other families will be missing loved ones at the Thanksgiving table who are hospitalized with COVID-19 or who have passed away from the virus over the past nine months.
Still others may be coping with a deployment or a divorce, separation or estrangement that unfolded during the pandemic.
"What many people are going to experience this year, for a variety of reasons, is that their holiday table is not going to be as full as it normally is," said Kory Floyd, Ph.D., an author and professor of interpersonal communication at the University of Arizona. "Many American households are going to experience a sense of deprivation this year."
"Especially on a holiday, when it’s a time to celebrate and be around loved ones, that accentuates a sense of loneliness," he said.
Since we already know Thanksgiving will be different this year, there are things people can start to plan now to make the day less lonely, experts say.
Here are five tips to make Thanksgiving a joy-filled day regardless of who you are, or are not, spending it with:
1. Make a plan
Planning ahead the fun things you'll do on Thanksgiving, or the new traditions you'll start, can both help ease the stress and uncertainty of the day and help you from obsessing over what could have been, according to Floyd.
"Think now of things you’ll plan for that day that will be positive distractions," he said. "The benefit of [planning ahead] is we’re ready and we’re prepared, and we’re prepared to enjoy and find meaning and find joyfulness in whatever we do with that time."
Planning ahead can be as detailed as what time you'll eat meals and do activities to a more general list of the movies you want to watch or the activities you can do outside in fresh air, experts say.
Floyd recommends planning something that feels indulgent on what is still a special day of the year.
"What feels indulgent to people will vary from person to person," he said, giving examples of a bubble bath or a decadent dessert. "But make it something that goes beyond the ordinary and feels really special and allow yourself the freedom to enjoy it, to lean into it."
2. Find ways to help other people
Doing something good for someone else can take the focus off yourself and help ease feelings of loneliness or discontent, according to Nicole Beurkens, Ph.D., a holistic child psychologist and the founder and director of Horizons Developmental Resource Center in Caledonia, Michigan.
Amid the coronavirus pandemic, that could mean dropping items off at a nursing home, preparing boxed meals for neighbors or delivering books and needed items to women's and children's centers, recommends Beurkens.
"Sometimes the best way to soothe ourselves is to do something outside of ourselves," she said.
3. Phone a friend or loved one
Even if you can't physically be with your loved ones on Thanksgiving, it's important to find ways to stay in touch with people, recommend both Floyd and Beurkens.
"Over the course of the pandemic, we haven’t nationally seen an increase in average levels of loneliness, and in fact they’ve been trending slightly in the opposite direction," said Floyd. "One of the explanations for that is we have so adapted to all of the communication modalities that we have available to us. We have so many ways to connect now."
Plan ahead to make sure you can call, Skype or Zoom with friends and relatives on Thanksgiving, whether it's just talking to catch up or taking part in holiday traditions together via technology. If the technology is too much, spend the down time you may have that day writing letters to family and friends or simply thinking about who in your life you're grateful for.
4. Think ahead to next year
While it's normally important to stay in the moment and not look ahead or behind, experts say this year it is fine, and even healthier, to already look ahead to Thanksgiving 2021.
"It gives a sense of forward-looking motion that helps people not feel as heavy a sense of what is going on now," said Floyd. "It reminds people that this is temporary and things will get better."
Floyd said he is reminding his patients that no matter how bad this year feels, it is temporary, and it is okay to start thinking ahead to things like travel and gathering again in-person with family and friends.
His advice is to be specific when thinking about the future, picturing things like exactly where you want to travel to, who you will spend Thanksgiving with next year and what new traditions you may want to start.
5. Be okay with shedding some tears
The advice from experts like Floyd and Beurkens is not meant to make people feel like they should not feel sad or lonely, they say, but to help them see and get to what's next.
"It's not getting over the emotions, but getting through them," said Floyd. "The last thing people should do is be ashamed of those emotions."
Both experts say it's okay and perfectly normal to spend a few moments on Thanksgiving shedding tears or sitting for a bit with grief over what a strange holiday, and year, this has been.
"The strategies I’m talking about here are what to do next so that emotion doesn’t become the focus of the day," said Floyd. "We can still generate joy even though there’s a sense of sadness or a sense of loss."
If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting HOME to 741741. You can reach Trans Lifeline at 877-565-8860 (U.S.) or 877-330-6366 (Canada) and The Trevor Project at 866-488-7386.
Copyright © 2020, ABC Audio. All rights reserved.
Courtesy of the Werner familyBy HALEY YAMADA and ROBERT HENAULT, ABC News
(NEW YORK) -- Carl Werden wants to serve as a warning for others who contract COVID-19 and may not be as lucky as him.
"I never realized how terrifying it is not being able to breathe," said the 57-year-old, who is currently recovering after a double lung transplant.
Werden developed lung fibrosis, a complication due to his battle with COVID-19, and said he was left with no other choice.
"[COVID-19] damaged my lungs so bad that I got to the point where there was no other option left but a lung transplant, because my lungs were just going to get worse," Werden told ABC News.
Werden contracted COVID-19 earlier this year and, although he recovered from the virus itself, he became critically ill while traveling from South Carolina to Connecticut in June.
On June 26, Werden was hospitalized in Hartford, but as his condition worsened he was transferred to Brigham and Women's Hospital in Boston.
"There's only about 120 hospitals in the country that do lung transplants so it's a very small number of hospitals," said Dr. Hari Mallid, program and surgical director of the lung transplant program at Brigham and Women's Hospital.
"When [Carl] arrived we repeated some of the CAT scans which confirmed the diagnosis that the COVID-19 had done pretty extensive damage to his lungs and really his only treatment at that point was a lung transplant," said Mallid.
Mallid told ABC News that the transplant was necessary if Werden was going to live.
"He would've ended up on a ventilator and gradually gotten worse and worse until there was basically nothing we could do to keep him alive," said Mallid, who performed Werden's operation on Oct. 29.
Werden is now recovering and working to gain strength in his new lungs. Mallid said that Werden is doing "remarkably well."
"He was taken off the ventilator fairly quickly after the transplant, he's walking around the hospital, even before he went to rehab, his appetite is coming back," Mallid told ABC News.
Werden said he has many things to be thankful for.
"I'm thankful to the person I got the lung[s] from. I'm thankful to the doctors that did the surgery. I'm thankful for my family because they were always there for me," said Werden, whose family has set up a GoFundMe page to help cover his medical expenses.
While Werden is doing well, he still has a long road to full recovery.
"I was a completely healthy person, nothing wrong with me, and look how [COVID-19] affected me," said Werden. "[People] need to take it seriously because all they have to do is look at me."
Copyright © 2020, ABC Audio. All rights reserved.
artisteer/iStockBy NICOLE PELLETIERE, ABC News
(NEW YORK) -- Safety experts are warning families of children being more exposed to poisonous household items, as COVID-19 has brought an abundance of disinfectants and sanitizing products into homes.
According to the American Association of Poison Control Centers and Centers for Disease Control and Prevention data, there was an increase in accidental poisonings since the start of the pandemic, with the AAPCC reporting 21,074 hand sanitizer exposure cases reported to 55 poison control centers. These cases took place from Jan. 1, 2020, through Aug. 2, 2020, a rate nearly 70% higher compared to the same time period during 2019.
Emily Samuel, program director at the nonprofit child safety organization Safe Kids Worldwide, said the heightened numbers are likely due to consumer demand for household cleaners, disinfectants and hand sanitizers during COVID-19. In addition, more people are home and balancing remote work, child care and homeschooling.
"So it is likely that the combination of balancing these priorities, more cleaning products in the home and gaps in supervision are leading to an increase in the number of calls to poison control centers related to young children getting into cleaning products," she told Good Morning America.
Here are Samuel's tips on how to avoid accidental poisonings.
1. Store household products out of children’s reach and sight. Young kids are often eye-level with items on counters and under kitchen and bathroom sinks. Keep cleaning supplies, laundry packets, hand sanitizers and personal care products where children can’t reach.
2. Keep household products in their original containers, and read product labels. Use and store products according to the product label. Kids can get into things quickly, so remember not to leave cleaning products or personal care products unattended while you are using them.
3. Store the Poison Control help number in your phone, and post it visibly inside your home: 1-800-222-1222. Specialists at poison control centers provide free, confidential, expert medical advice 24 hours a day. They can answer questions and help with possible poison emergencies.
Copyright © 2020, ABC Audio. All rights reserved.
Buggie HuggieBy THE GMA TEAM, ABC News
(NEW YORK) -- Nichole Clark ran into a problem familiar to many moms when she would take her middle son, Jonah, now 4, shopping with her.
"When we would go to the store, just getting him in the shopping cart would be a wrestling match," Clark told Good Morning America. "Then it would take just three seconds for him to lean out and reach for something, or I could turn my head and he was already one leg out [of the cart]."
When Jonah fell out of a shopping cart for the third time, hitting his head, Clark, also mom to 8- and 2-year-old sons, decided to find a solution.
"I just had this idea: What if we had something that went around him that would keep him safe inside the cart?" she said. "I thought if there was a tray that fit around him, and then he had place for his snacks and I could put some toys out for him to be entertained."
With that idea in mind, Clark got to work with her husband and father-in-law designing a shopping cart safety seat for her to use with Jonah.
When Clark went out with Jonah using the seat, she said she quickly learned she was not the only mom facing the same issue of shopping cart safety.
"As moms you take on this guilt, like you're the only one with this problem, that you're the only one who can't corral your kid," she said. "The more I went out the more I realized that other moms had this problem ... other moms would stop me and say, 'Where did you get this?'"
Inspired by the need, Clark, a stay-at-home mom and homeschool teacher to her sons, decided to keep perfecting the safety seat so she could help other moms.
Less than two years after Clark and her husband, Jeff, started building a safety seat for their son in their garage, they launched their company, Buggie Huggie.
Their $39.95 Buggie Huggie shopping cart tray is a portable tray that goes around the child and clips on to the shopping cart. It can fit children up to 50 pounds and then collapses to fit into a diaper bag, according to Clark.
"Immediately when a mom sees the product, they get it," she said. "I've had that expectation all along, that this will bring peace to moms and will bring safety to kids."
Between 2008 to 2008, there were more than 100,000 emergency department-treated injuries associated with shopping carts to children younger than the age of 5, according to data shared by the Consumer Product Safety Commission (CPSC).
The CPSC cites falls from shopping carts as among the leading causes of head injuries to young children, and recommends that parents keep children restrained by a seatbelt in the cart seat.
Buggie Huggie states on its website that the product has "passed all testing requirements" with the CPSC.
The product, which is now available online, is described by Clark as being "something really beautiful" that came out of her family's difficulty. Jonah, who sparked the idea for the invention, and his brothers all played important roles in bringing Buggie Huggie to life, according to Clark.
"The kids have been a big part of it the whole time," she said. "They're excited too."
Copyright © 2020, ABC Audio. All rights reserved.
Children's Healthcare of AtlantaBy GENEVIEVE SHAW BROWN, ABC News
(ATLANTA) -- Reunited and it feels so good for these tiny twin sisters.
Four-month-olds Justice and Journee Altidor have spent much of their short lives apart. But now, just in time for the holidays, they're together once more.
"It's a dream come true to have them reunited. I can't imagine the separation anxiety they probably experienced being separated as soon as they were born," their mother, Emanuella Altidor, told Good Morning America.
Prior to birth, Justice was diagnosed with a heart abnormality, a double aortic arch. She has been followed by cardiologists at the Children's Healthcare of Atlanta Heart Center since. She underwent her first open heart surgery at just 11 days old to repair her heart defect.
Despite surgery, she continued to experience trouble breathing from her collapsed airway and was placed on a ventilator. She needed an additional surgery, a 3D tracheal splint surgery.
On Oct. 6, Justice became what Children's believes to be the youngest person ever to undergo this surgery. Only 30 have ever been done nationwide. The procedure involves surgically implanting a 3D printed Airway Support Device.
"Justice's future is bright," said Dr. April Landry, pediatric otolaryngologists at Children's, who was one of two doctors to perform the surgery. "She will continue to be followed closely to monitor her breathing and eating, but she is expected to have a normal childhood."
She called part of the procedure "humbling. With this technology, we are able to achieve outcomes that would not have been possible even five years ago."
The girls' mom said they "feed off of each other's energy."
"When one is happy and playful the other does the exact same thing," Altidor told GMA. "Unfortunately, it also is true for crying too."
With Justice finally home with her family, the family is looking forward to the upcoming holidays.
"We are looking forward to capturing all of their first moments together," their mom said. "We love the holidays so we have a special outfits for every occasion."
Copyright © 2020, ABC Audio. All rights reserved.
vladm/iStockBy LAURA ROMERO, ABC News
(NEW YORK) -- As coronavirus cases and hospitalizations in the U.S. continue to set new records, blood centers and hospitals are sounding the alarm again over a shortage of donations amid the ongoing closure of schools, colleges and other collection locations.
Blood donations are not only important for conducting important surgeries and treating those with serious illness, but also affect the ability to harvest convalescent plasma, an antibody-rich serum made from the blood of recovering COVID patients that is used to treat those who are seriously ill.
According to America's Blood Centers, 13 community blood centers have a one-day supply or less while 22 centers have a two-day supply or less. The organization has 59 community blood centers across the country.
The issue is particularly acute in the rural healthcare system, where medical facilities rely on blood to stabilize patients while they are transferred to other facilities.
In New York alone, high schools and colleges account for 75,000 donations each school year.
“Across our state and country, we are seeing an alarmingly low supply of blood,” said Dr, Joan Uehlinger, the director of transfusion medicine at Montefiore Health System, in a statement released by the New York Blood Center.
To prepare for the winter, a typically slow season for blood donations, the Blood Center has partnered with hospitals to increase donations. Currently, in New York, donations are at just 65% of pre-pandemic levels, well below what is needed by hospitals.
“Giving blood was as easy as skipping chemistry,” Andrea Cefarelli, senior executive director at the New York Blood Center, told ABC News. “But with school and college campuses closed as well as other locations like places of worship, there is a chronic deficit between what we need and how many people are giving blood.”
Cefarelli said she is concerned that hospitals may cancel elective surgeries, a step they took in the spring amid the initial surge in cases.
Dr. Justin Juskewitch, a clinical pathologist at Mayo Clinic, echoed similar concerns about "individuals who have cancer, individuals who need to undergo surgeries, trauma patients.”
“These are individuals who require blood transfusions," Juskewitch said. "There’s a lot of need.”
Versiti, a healthcare organization that supplies blood in Wisconsin, Indiana and Michigan is reporting a shortage in blood supply and convalescent plasma as well (a treatment for severely ill COVID-19 patients made from the blood of those who recovered).
Last week, the organization issued an urgent plea to coronavirus survivors to donate.
Even though the company started collecting plasma early on, Dr. Dan Waxman, the vice president of transfusion medicine and senior medical officer at Versiti, told ABC News that about a month ago, distribution started to increase beyond what the company is collecting.
“We’ve had to bring in plasma from other parts of the country to meet the needs of hospitals,” said Waxman. “It’s a real problem. The demand just in the last three to four weeks has shot up exponentially.”
Paul Sullivan, the senior vice president at the American Red Cross told ABC News that the organization is also seeing a "significant" shortage of convalescent plasma.
"We are sending convalescent plasma to our hospitals at a rate faster than we're collecting it," Sullivan told ABC News. "So we need to obviously turn that around. Demand is high and we need more people to come out to our blood drives."
For Dr. Jay Bhatt, a practicing internist and ABC News contributor, doctors are having to “think creatively” about blood supply to have enough for patients in need.
“The wave of blood supply shortages we are seeing is deeply concerning and pushing caregivers to the brink of not having a vital substance to save lives,” Bhatt said. “We can't sustain more cases.”
In Delaware, Beebe Healthcare announced a partnership with the Blood Bank of Delmarva to make up for the shortfall caused by the coronavirus pandemic.
The healthcare system’s CEO, Dr. David Tam, said he is concerned about the impact blood shortages have on rural healthcare systems. He said they depend on blood to stabilize patients who are later transferred to a place with a higher level of care.
Mobile donations at the Blood Bank of Delmarva are at just 43% of pre-pandemic levels.
“Having worked in emergency rooms and trauma rooms for many years, I know there are situations where you can use your entire hospital blood supply on one patient,” said Tam. “Everyone needs to donate.”
“Blood is necessary,” said Tam. “It saves lives.”
Copyright © 2020, ABC Audio. All rights reserved.
simon2579/iStockBy LUIS MARTINEZ, ABC News
(WASHINGTON) -- Gen. Gustave Perna, who is leading Operation Warp Speed's effort to distribute coronavirus vaccines nationwide, told ABC News he is confident that vaccines will be "on the street" and headed to communities just 24 hours after being authorized by the Food and Drug Administration.
While the first two vaccines to be distributed will likely be from Pfizer and Moderna, Alex Azar, the U.S. secretary of health and human affairs, described the news from Astra Zeneca's clinical trials as "very promising" and noted that the company's vaccine is already being produced in the country so it too can be ready for distribution once authorized by the FDA.
Perna and Azar made their comments in exclusive interviews with ABC News' correspondent Bob Woodruff during a visit to Operation Warp Speed's offices at the U.S. Department of Health and Human Services (HHS).
"The news from Astra Zeneca and Oxford, is very important, and of course, very promising," Azar told Woodruff.
According to Azar, the drugmaker is already producing mass quantities of the vaccine in the U.S. as part of a $1.2 billion support plan announced by HHS. Under the deal, Astra Zeneca will have to provide 300 million doses of its vaccine in the U.S. once the vaccine is authorized by the FDA.
The parallel manufacturing of the vaccines -- while clinical trials are underway to measure their effectiveness -- is a hallmark of Operation Warp Speed's plan to make large quantities of a coronavirus vaccine quickly available in the country.
"We're going to be ready to distribute vaccines within 24 hours" after they receive emergency use authorization from the FDA, Perna told Woodruff.
Last week, Pfizer applied for authorization from the FDA and a hearing date was set for Dec. 10 to discuss the vaccine's possible authorization.
Perna believes the FDA's authorization, which he calls "D-Day," could occur between Dec. 10 and Dec. 14. Once it's authorized, he said, "24 hours later, vaccines are on the street."
At that point, the six million doses of Pfizer's vaccine will begin being distributed to 64 jurisdictions, the 50 states, eight territories and six metropolitan cities.
Perna said, "3 million we'll send out, the other 3 million we'll send out 21 days later because we want to make sure the second dose is available for everybody."
An additional 400,000 doses will be kept in reserves for any unforeseen circumstances.
"Pfizer's going to distribute it directly down to our administration sites," Perna said. "They're going to use FedEx and UPS to get it there. They know how to do this. They do it all the time."
Separately, Operation Warp Speed will send large vaccine kits, for up to 975 doses, containing needles, syringes, alcohol swabs, face masks and face shields needed to administer the vaccine. Most importantly, the kits will include cards for those receiving the vaccine, reminding them to get a second dose of the vaccine in three weeks.
When authorized by the FDA, the vaccine made by Moderna will be included within smaller kits, with similar materials, for up to 100 doses that will be transported by the McKesson Corporation to administration sites.
Azar expressed confidence that there will be no changes to Operation Warp Speed under Joe Biden's administration.
"It won't change anything about the process because we will ensure a professional cooperative effective transition," Azar said.
He noted that the personnel at the Centers for Disease Control and Prevention, National Institutes of Health, FDA, U.S. Department of Defense and HHS involved in Operation Warp Speed are all career people.
"They don't change, they're the same people on Jan. 19, as they are on Jan. 21," he said.
"We will ensure continuity, and by then -- by the time of any transition -- we believe many tens of millions of Americans will already have been vaccinated, and the mission of the next administration will be to simply not mess up what we've got going," Azar said.
As to whether Biden has information about the vaccines right now, Azar said "he and all Americans have it already, we have been completely transparent" about all of their plans.
Azar said he will take any of the vaccines as soon as he is allowed to do so, to show "the American people, the unvarnished confidence in the integrity and independence of the process."
Copyright © 2020, ABC Audio. All rights reserved.
enviromantic/iStockBy DR. L. NEDDA DASTMALCHI, ABC News
(NEW YORK) -- For decades, doctors have been searching for a surefire way to prevent atrial fibrillation, an abnormal heart rhythm that can prove fatal. Now, a new, high-quality study has ruled out two possible contenders: vitamin D and fish oil supplements.
The trial, called VITAL-Rhythm, took center stage at a recent virtual conference of the American Heart Association (AHA), the nation's largest professional organization of doctors who focus on the heart and cardiovascular system.
"Atrial Fibrillation is a very common condition and is hard to treat," said Dr. Christine Albert, the study's lead author and chair of the Department of Cardiology in the Smidt Heart Institute at Cedars-Sinai. "There are an estimated 33 million people in the world with atrial fibrillation."
Atrial Fibrillation is not benign, she explained. If left untreated, it can lead to serious health consequences such as stroke, heart attacks, heart failure, dementia, and even death. Although early, less reliable studies hinted that vitamin D and fish oil might help, doctors said this new study shows they don't make a difference.
Doctors said it's a relief to see high-quality evidence like this, because it means they can focus on new research frontiers, and avoid prescribing unnecessary pills to their patients.
Prior studies identified a possible link between these supplements and atrial fibrillation rates, but it wasn't clear if these differences were caused by the supplements themselves, or by some other unexplained factor, such as lifestyle choices.
Albert and her research team embarked on a massive study comprised of 25,000 volunteers, who would be randomly selected to receive vitamin D, fish oil or a placebo pill.
Dr. Erin Michos, the director of women's cardiovascular health and the associate director of preventive cardiology at the Ciccarone Center for the Prevention of Cardiovascular Disease at Johns Hopkins University Medical Center, said the study received praise at this year's American Heart Association conference because it was a high-quality study that included diverse volunteers. This means that the findings are applicable regardless of race and gender.
"They studied vitamin D at 2000 IU per day compared to placebo, while simultaneously studying 840 milligrams a day of marine Omega-3s vs placebo. This was a randomized clinical trial and blinded, so participants did not know whether they were taking a supplement or placebo," Michos said.
Historically, large trials have been victim to underrepresentation and lack of diversity, making it difficult for clinicians to apply these trials to their true patient population. This study, meanwhile, represented a larger population of African Americans and women.
Michos said that the importance of having a strong representation of African Americans in this trial was critical. Many have a lower blood levels of vitamin D as a result of darker skin pigmentation, which leads to poor absorption of UVB light, which is necessary to create active vitamin D and utilize its benefits.
"I actually applaud the study investigators for their efforts in diversity in this trial," Michos said. "Twenty percent enrollment of Blacks means they were overrepresented relative to their proportion in the U.S. population."
In addition, Michos said that women are frequently underrepresented in cardiovascular trials, which usually limits doctors' understanding of whether a drug or treatment will work just as well in women as it does in men.
"However, this was not the case in VITAL- Rhythm trial," Michos said. "The VITAL trial enrolled 51% women."
In recent years, research has shown a behavioral shift among some Americans toward a rise in the consumption of supplements: an estimated 120 billion dollar industry.
But researchers say the true health benefits of supplements are often overstated.
"For the vast majority of supplements, there does not appear to be any benefit. Again, more is not better if one does not have a nutritional deficiency. Some high dose supplements can even cause harm," Michos said.
The evidence is growing that supplements do not prevent primary or repeated cardiovascular disease. Another study debut at AHA, the OMEMI trial, showed no benefit in adding marine n-3 polyunsaturated fatty acids supplements to prevent a second heart attack.
But what has been shown, repeatedly, is the benefit of diet and exercise in preventing, or at times even reversing, conditions like atrial fibrillation.
"We tend to look for the magic nutrient so we do not have to eat good food," Albert said.
Albert said the most effective prevention is maintaining a healthy weight, reducing alcohol intake to 1-2 drinks per day and maintaining a healthy blood pressure.
Michos agreed -- she advised that a healthy lifestyle and dietary behaviors can prevent not only atrial fibrillation, but cardiac disease overall.
"Moderate exercise, following a healthy diet, maintaining a normal weight can decrease the risk of atrial fibrillation. I think the individuals would be better served by saving their money on supplements, which have not been shown to work, and instead focus their time and money on activities that promote a healthy lifestyle," she said.
Copyright © 2020, ABC Audio. All rights reserved.
katleho Seisa/iStockBy DR. MOLLY STOUT, ABC News
(NEW YORK) -- Blue, white and red are not just the colors we've been seeing everywhere due to the recent U.S. election -- you may be seeing these colors on your fingers and toes due to the cooling temperatures. It's a medical condition called Raynaud's syndrome.
Although Raynaud's is not life-threatening, if you notice your fingers or toes turning red, white and blue this winter, you should speak to your dermatologist. For some, Raynaud's is the first sign of an underlying illness, and there may be lifestyle changes and medical treatments that can help.
What is Raynaud's syndrome?
Raynaud's occurs when blood vessels in the fingers or toes suddenly narrow or spasm, leading to a blue discoloration, followed by a sharply demarcated pale white discoloration, and finally, a red discoloration. It can often be symmetric, affecting fingers on both hands. The phenomenon was first described by the 19th century French medical student Maurice Raynaud.
"It's really an exaggerated cold response: When our body is cold it's normal for our blood vessels at the periphery, such as in our fingers, to narrow to conserve core body heat," said Dr. Emily Kiemig, a dermatologist and assistant professor at Northwestern's Feinberg School of Medicine in Chicago, who specializes in connective tissue and autoimmune diseases of the skin, and frequently cares for patients with Raynaud's.
"It's normal for fingers to turn a little blue when we're in a cold environment," she said, but when someone has Raynaud's, their blood vessels narrow, even at modestly cool temperatures, and remain clamped for long periods of time. Once the blood vessels return to a normal caliber, "blood flow rushes back in and the fingers will turn red."
In the U.S., we are entering Raynaud's season. The phenomenon is classically triggered by cold, but can also occur with vibration or emotional stress. It has been described occupationally in people who operate weed whackers and jackhammers.
Raynaud's can be split into two categories: Primary Raynaud's, also called Raynaud's disease, and Secondary Raynaud's, when the changes occur in the context of an underlying condition.
"On a personal note, I have Raynaud's, and the first time I noticed it, I was in the freezing library studying for medical school exams," Keimig said, "turns out, stress combined with cold can be a potent Raynaud's trigger as well."
I think I may be experiencing Raynaud's, how do I know for sure?
The appearance of Raynaud's is often alarming. A starkly white finger or group of white fingers in response to cold is typically the herald sign.
"Some physicians say you need to see all three colors, while some say you need just need to have the blue and the white, without the redness," Kiemig said.
For those who suffer from Raynaud's, it's not only the winter months that trigger flares, sometimes even a trip to the frozen aisle of the grocery store on a summer day is enough to bring it on.
Symptoms of Raynaud's may include numbness, tingling, discomfort and even throbbing pain. People who develop ulcers at the tips of the fingers should seek timely medical evaluation as breaks in the skin can lead to infection.
I think I have Raynaud's, what should I do next?
"The first thing to do if you notice the changes of Raynaud's is not to panic," Keimig said. Fortunately, the vast majority of people with Raynaud's have the primary version and do not have to worry about an underlying disease.
Flareups typically last 15 to 20 minutes, and gradually go away as you warm up.
"There is really no gold standard testing for Primary Raynaud's, such as X-rays or blood tests," Keimig said.
People who notice this phenomenon should bring it up to their primary care doctor or dermatologist, as conditions that go along with Secondary Raynaud's may be silent and Raynaud's may in fact be the first warning sign. These conditions include autoimmune diseases such as systemic sclerosis, dermatomyositis and lupus, which can have devastating effects on the entire body. Dr. Keimig specializes in such diseases, and frequently sees patients with Raynaud's disease in her clinic who are undergoing evaluation for another underlying disease.
I've been diagnosed with Raynaud's, what's next?
"If you've been diagnosed with Primary Raynaud's, there are a few lifestyle modifications that are important because it doesn't take a lot to trigger it. You don't necessarily need a polar vortex to bring this on," Kiemig said.
Keimig encourages all her patients with Raynaud's to dress in layers, and "literally put gloves in your car's glove compartment." Patients with Raynaud's should even consider having an insulator koozie or putting gloves on when holding a cold beverage.
"Don't forget to keep the core warm," Keimig said, since the whole reason the phenomenon occurs is because the body is trying to conserve its central body heat to help keep its vital organs working.
For those with Raynaud's flares, Keimig recommends immersing hands in warm -- not hot -- water, or running tap water.
"You don't want to develop a thermal burn," she cautioned.
Finally, those who smoke cigarettes should consider quitting, as nicotine can be damaging to the blood vessels.
Your doctor may also take a look at your medications as certain stimulants and chemotherapeutics can trigger Raynaud's disease.
How is Raynaud's treated?
The first thing you should do to keep from getting Raynaud's flareups is avoiding triggers.
If symptoms do develop, your primary care doctor may prescribe you a medication. Blood pressure medications have been repurposed due to their effect on relaxing the blood vessels in fingers.
"The basis of all treatments for Raynaud's is to relax the peripheral blood vessels," Kiemig said.
Calcium channel blockers are a class of blood pressure medication most frequently used to treat stubborn Raynaud's. Others, such as topical nitroglycerin paste, sildenafil and certain antidepressants, can also be helpful.
"All these medications need to be prescribed by a physician familiar with Raynaud's and the side effects of the medications," Keimig said.
For patients with very severe Raynaud's, who have ulcerations, Botox injections can even be helpful.
"Botox blocks the signal from the nerve endings to the blood vessels, so they never get the signal to clamp up," Kiemig said.
Botox injections can be performed by hand surgeons or dermatologists for Raynaud's patients with unrelenting ulcerations and infections. Rarely, a procedure called a sympathectomy can be used to block the nerve signals as well.
Copyright © 2020, ABC Audio. All rights reserved.
Bill Oxford/iStockBy MORGAN WINSOR, ABC News
(LONDON) -- U.K.-based pharmaceutical giant AstraZeneca and England's University of Oxford announced Monday that late-stage trials show their COVID-19 vaccine was up to 90% effective in preventing the disease.
The results are based on interim analysis of phase 3 trials in the United Kingdom and Brazil, which looked at two different dosing regimens. One regimen showed vaccine efficacy of 90% when the drug, called AZD1222, was given as a half dose, followed by a full dose at least one month apart. A second regimen showed 62% efficacy when given as two full doses at least one month apart. The combined analysis from both dosing regimens showed an average efficacy of 70%, according to press releases from AstraZeneca and Oxford.
There were a total of 131 COVID-19 cases in the analysis, and no hospitalizations or severe cases of the disease were reported in participants receiving the vaccine candidate, according to the press releases.
"These findings show that we have an effective vaccine that will save many lives," Andrew Pollard, director of the Oxford Vaccine Group and chief investigator of the Oxford vaccine trial, said in a statement Monday. "Excitingly, we’ve found that one of our dosing regimens may be around 90% effective and if this dosing regime is used, more people could be vaccinated with planned vaccine supply."
AstraZeneca, which has promised not to profit from the vaccine "for the duration of the pandemic," said it will now immediately prepare to submit the data to regulators around the world -- including in the United Kingdom, Europe and Brazil -- that have framework in place for conditional or early approval. The company will also seek an emergency use listing from the World Health Organization for an accelerated pathway to vaccine availability in low-income nations.
Meanwhile, Oxford said it is submitting the full analysis of the interim results for independent scientific peer review and publication.
"Today marks an important milestone in our fight against the pandemic," AstraZeneca CEO Pascal Soriot said in a statement Monday. "This vaccine’s efficacy and safety confirm that it will be highly effective against COVID-19 and will have an immediate impact on this public health emergency."
Clinical trials of AZD1222 are also being conducted in the United States, Japan, Russia, South Africa, Kenya and Latin America, with planned studies in other European and Asian countries. In total, AstraZeneca said it expects to enroll up to 60,000 participants globally.
The company said it is "making rapid progress in manufacturing" and expects to produce up to 3 billion doses of AZD1222 in 2021 on a rolling basis, pending regulatory approval. The vaccine can be stored, transported and handled at normal refrigerated conditions for at least six months and administered within existing health care settings.
"The vaccine’s simple supply chain and our no-profit pledge and commitment to broad, equitable and timely access means it will be affordable and globally available, supplying hundreds of millions of doses on approval," Soriot said.
The U.K. government has already placed orders for 100 million doses of the AstraZeneca/Oxford vaccine candidate, along with 40 million doses of another developed by Pfizer and BioNTech, which has shown in a phase 3 trial to have 95% efficacy with no serious safety concerns to date.
Pfizer and BioNTech announced Friday that they had submitted a request to the U.S. Food and Drug Administration for emergency use authorization of their COVID-19 vaccine candidate.
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