ABC - Health News

Powerofflowers/iStockBy DR. LEAH CROLL, ABC News

(NEW YORK) -- It's been six months since the World Health Organization first declared COVID-19 as a pandemic. Since then, over 30 million people worldwide have been infected, and we're rapidly approaching 1 million global deaths.

The U.S. is among the world's most-affected countries, now hitting a sobering milestone: 200,000 American lives lost to COVID-19.

"This is our worst global pandemic in more than a century. And it is incredibly distressing to see the consequences. It's heartbreaking to see the ones who have been lost, the families who are grieving, other people whose livelihood has been incredibly disrupted by the economic consequences," director of the National Institute of Health, Dr. Francis Collins, told ABC News' Bob Woodruff.

Unfortunately, experts say things could get worse before they get better.

"I do think we're going to see deaths continue to increase, we'll probably expect to see another 100,000 milestone in the coming months. But I think because we've learned so much, the hope is that we'll be able to react more quickly than we were at the beginning stages of the pandemic," said John Brownstein, Ph.D., ABC News contributor and epidemiologist at Boston Children's Hospital.

Here’s what we can expect over the next six months:


Cooler months herald both flu season and fear of worsening COVID-19 outbreaks


Experts warn that colder weather and drier air will result in an uptick of COVID-19 cases this winter.

"As the colder weather will drive people indoors, we have to anticipate that there may be an acceleration in transmission and be prepared to handle the increased number of cases that may result," Amesh Adalja, MD, FIDSA, infectious disease specialist and Senior Scholar at the Johns Hopkins University Center for Health Security, told ABC News.

When flu season coincides with the ongoing pandemic, we'll have an even bigger challenge on our hands.

"If there's ever a year that you need to get your flu vaccine, get your kids vaccinated, this is the year because you really need every single protection that you can get against COVID-19. You also don't want to get exposed to COVID-19 when you're sick from another virus," Jeanne Marrazzo, MD, MPH, FIDSA, Director of the Division Infectious Diseases at the University of Alabama at Birmingham, said during an Infectious Diseases Society of America media briefing on Sept. 10.

A vaccine could be approved by 2021, but it won't be available widely for months


Public health officials say it's possible that a vaccine could be approved by the end of the year. But, approval is just the first step. Following approval, we'll need to tackle the logistical challenges of producing enough doses and distributing them fairly to everyone.

"By the time you mobilize the distribution of the vaccinations and you get the majority or more of the population vaccinated and protected, that's likely not going to happen until the mid- or end of 2021." Dr. Anthony Fauci, the nation's top expert on infectious diseases, told MSNBC's Andrea Mitchell. And that's assuming that one of the vaccine candidates works.

"But boy, Americans, we need to figure out this is not going to be a sudden snap of the fingers in December or January and everything will go back to the way it was. We're going to have many more months after that to gradually get readjusted," said Collins.

Vaccine hesitancy and pandemic fatigue will be major hurdles


Pushback on tried-and-true interventions like mask-wearing and social distancing pose serious threats to our efforts to control the spread of COVID-19. Rising vaccine safety concerns are only piling on to the problem.

"In the best of times, there are groups of people who mistrust vaccines. So that's a problem we're going to face. And if you can't get people vaccinated, we're back to where we started," Brownstein said.

As the pandemic evolves, experts are worried we will see more people become complacent with the recommended precautions.

"We are starting to see pandemic fatigue. People are getting numb to these numbers. As the numbers keep going up, people don't see the humanity in the statistics," Brownstein said.

The humanity of this particular milestone, however, is unavoidable. The virus has killed many more Americans than those who died in World War I and the Vietnam War combined. It's almost 70 times deadlier than the 9/11 attacks. Collins warned: "It's not the right time to say we're done with this. We are not. The virus is not done with us."

"We've been saying some of the same things for six months straight, and there's still an unwillingness to accept evidence-based public health decision making," said Brownstein.

We know what we have to do moving forward


We've learned a number of important lessons in the first six months: Masks and social distancing keep you and others safe. Avoiding indoor gatherings makes a big difference. Widespread testing and contact tracing are essential for controlling transmission. The flu vaccine will protect us from an even worse situation.

"Behaviors that we know work to keep the virus down may help to make the second wave not as big as we expect," Brownstein said. "But it's a matter of what this country is willing to do to stop it because we have the tools, we know what works. We have empirical evidence of these interventions, so the question is, are we willing to keep this up for another six months?"

"We ought to all look at the evidence and then make an individual decision to live up to that, because that's our best hope. Until that vaccine is in hand, and lots of people have been able to receive it, we've got many more months yet with lives at risk. And the best way to save them is for us all to take this on our own shoulders," said Collins.

We may start approaching a new normal in late spring-early summer 2021


If a vaccine is successfully deployed and public health interventions go to plan, things will begin to reopen slowly and carefully.

"If you're talking about getting back to a degree of normality, which resembles where we were prior to COVID, it's going to be toward the middle of 2021, maybe even end of 2021," said Fauci.

But, it's unlikely that life will be exactly what it was before the pandemic.

"The biggest challenge will be learning to have this virus amongst us and being able to go about our daily lives," Adalja said. "This will require an enormous amount of risk calculation for which the general public has not really had a precedent since before the measles vaccine."

Leah Croll, M.D., is a neurology resident at NYU Langone Health and a contributor to the ABC News Medical Unit.

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Xesai/iStockBy KATIE KINDELAN, ABC News

(NEW YORK) -- As the United States crosses the grim milestone of 200,000 COVID-19-related deaths, experts are warning about a less visible but worrisome outbreak happening simultaneously: increasingly poor mental health.

More than half of U.S. adults -- about 53% -- reported that their mental health has been negatively impacted due to worry and stress over the pandemic, according to a nationwide poll by the Kaiser Family Foundation.

That number is a significant increase from the 32% who reported being similarly affected in March, showing that as the pandemic continues into its seventh month and the death rate continues to climb, so, too, does the toll on people's mental health.

"Keep in mind that in the U.S., we've been kind of in a mental health decline for some years now," Dr. Rheeda Walker, a psychologist and the author of The Unapologetic Guide to Black Mental Health, told Good Morning America. "National reports that have examined mental health have shown increasing stress and increasing anxiety and people feeling increasingly overwhelmed, and that was pre-coronavirus."

"Coronavirus kind of puts all of that on steroids because of the level of disruption," she said. "People's everyday lives have been disrupted on almost every single level."

Mental health experts have called the pandemic a kind of "perfect storm" for negatively impacting mental health.

In addition to the fear, grief and anxiety around the virus itself, the pandemic has brought on for many people financial instability, job loss, isolation, uncertainty around school and work and related political disagreements.

Making the pandemic even more distressing from a mental health perspective, experts have said, is both its all-encompassing nature and the uncertainty that lies ahead.

"That's what makes COVID so unique, that we don't know who has it, we don't know how bad it's going to be or how long it's going to last, and most importantly, there's no one that is not directly impacted," said Dr. Robin Gurwitch, a psychologist and professor at Duke University Medical Center. "There is no place in the world, really, but certainly in the U.S., where you can go and say, 'I don't have to worry.'"

Mental health symptoms during the pandemic range from depression and anxiety to substance abuse and thoughts of suicide, data shows.

By late June, just 13% of adults had started or increased alcohol consumption or drug use to help cope with the pandemic, and 11% of all adults, and 25% of those ages 18 to 24, had seriously considered suicide in the past month, according to the U.S. Centers for Disease Control and Prevention (CDC).

At an even more basic level, people may see signs of mental health struggles pop up when they can't sleep or find themselves unmotivated to act or even overwhelmed at the state of the world, according to Walker.

"If someone wakes up and they've slept five hours because they had difficulty falling asleep, because they were worried about their job, when they wake up they feel like I've got all these things to do, but then in their mind they can't get themselves in gear, that's about our mental health, our psychological functioning," she said. "We need our minds in order to be able to function."

Two of the populations at highest risk for mental health struggles related to the pandemic may also be the most overlooked when it comes to mental health treatment, according to both Walker and Gurwitch.

Children, who are taking on the weight of a global pandemic, the stress of their parents, the isolation from friends and the uncertainty around schooling, cannot just be thought of as "resilient," according to Gurwitch, who specializes in child psychology.

"Sometimes people say, 'Oh, kids are resilient,' but we can't just throw that out and assume that this is not an issue," she said. "I really do think that we need to consider children's mental health right now more than ever."

"One of the things that's gone down is the resources available for children's mental health, and the other issue is that caregivers and parents of our children are also at risk," Gurwitch added. "We know that one of the most protective factors for children's mental health is a positive adult in their lives."

People of color are facing both a disproportionate impact due to the coronavirus and the upheaval surrounding instances of racial injustice and police brutality across the country.

African Americans, in particular, are already 10% more likely to experience serious psychological distress than other races, according to the Health and Human Services' Office of Minority Health. Experts agree that these alarming statistics will only increase without elevated access to coping mechanisms.

"The health problems have been persistent and because we've known about them, I think there's more anger and frustration now," said Walker, adding that the pandemic has also stripped away much of the social net for people. "With those [networks] diminished now, I do think we can see increased mental health challenges for African Americans and for other communities."

In addition to the health crisis and the crisis around racial injustices, Americans are also coping simultaneously with natural disasters, from hurricanes to wildfires.

With that in mind, both Walker and Gurwitch said they and other mental health experts are preparing for a mental health crisis that will last long after the virus is contained.

"What we know about disasters and large-scale traumatic events in general, and a public health emergency is certainly a large-scale traumatic event, is that the mental health issues are often much larger and more long lasting," said Gurwitch. "We need to be thinking about how we're going to address those currently, but also tomorrow and next week and next year."

"All these things are happening that by themselves are an increased risk for mental health problems," she added. "Put them together and stir and you've got a recipe for huge spikes in mental health."

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

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Rawpixel/iStockBy KATIE KINDELAN, ABC News

(ATLANTA) -- Halloween will need to be done differently this year in order to keep people safe amid the coronavirus pandemic, according to new guidelines issued Monday by the U.S. Centers for Disease Control and Prevention (CDC).

Door-to-door trick-or-treating, indoor haunted houses, costume parties and "trunk or treating," where children go from car to car to receive treats, are among the traditional Halloween activities the CDC has deemed "higher risk activities" that should be avoided this year.

In lieu of those classic Halloween activities, the CDC recommends people try what they describe as "lower risk activities" to celebrate the holiday this year amid the global pandemic.

Those activities include socially distanced pumpkin carving, decorating your house, having a virtual costume contest, doing an outdoors Halloween scavenger hunt and having a "scavenger hunt-style trick-or-treat search" indoors with members of your household.

The CDC says people can also consider moderate risk activities like small, outdoor costume parades, outdoor Halloween movie nights where attendees are spaced at least six feet apart and participating in one-way trick-or-treating that includes individually wrapped treats and social distancing.

While masks are a Halloween staple, a costume mask is not a substitute for the types of cloth face masks that protect people from the virus, according to the CDC.

People should also not wear a costume mask over a protective cloth mask because of possible breathing difficulties, warns the CDC.

Because COVID-19 is spread through particles in the air, the CDC has issued a special warning for another staple of Halloween festivities: Screaming.

"If screaming will likely occur, greater [social] distancing is advised,” the CDC advises. “The greater the distance, the lower the risk of spreading a respiratory virus."

The CDC's guidelines for Halloween come as the United States approaches the sad milestone of 200,000 American deaths due to COVID-19.

Amid the rising death toll, public health officials in Los Angeles County issued Halloween guidelines similar to the CDC's, saying trick-or-treating and trunk-or-treating are not recommended for residents.

Halloween carnivals, festivals, live entertainment and haunted houses will not be allowed in Los Angeles County this year, according to the guidelines issued earlier this month.

When it comes to making a decision about going trick-or-treating or heading to a gathering for a socially distanced Halloween celebration in your neighborhood, people should look at how the virus is spreading in their community, according to Dr. Edith Bracho-Sanchez, an assistant professor of pediatrics and director of the pediatric telemedicine program with Columbia University Medical Center.

"You want that [positive testing rate] number to be less than 5%, ideally even lower than that," she told Good Morning America earlier this month. "Then you want to look at the number of cases and the number of hospitalizations. They just give you a sense of how widespread COVID-19 is in your community and sort of the baseline level of virus that you're starting with before you even go out trick-or-treating or to another activity."

Factoring in who you live with is also important when it comes to making a decision on whether to spend Halloween with others this year, Bracho-Sanchez said. If you are an expectant mother with young kids, Bracho-Sanchez said you may want to be careful about protecting the baby -- even though there isn't any data available on the relationship between pregnant moms and the novel coronavirus. And if you live in a multi-generational household, with young kids in the family trick-or-treating, elderly relatives in that home may be put at higher risk.

"Look at your community and look at your family circumstances to try to make some of these decisions," said Bracho-Sanchez, adding that Halloween festivities this year are "something that communities are going to have to weigh community by community, and that families are going to have to weigh family by family."

ABC News' Angeline Jane Bernabe contributed to this report.


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Courtesy Nikki TeixeiraBy KATIE KINDELAN, ABC News

(NEW YORK) -- A mom in Canada is warning parents and caregivers after she says her young son ingested hand sanitizer thinking it was food.

Nikki Teixeira, of Manitoba, Canada, said her 18-month-old son, Logan, was with his grandmother last month when she handed him what she thought was a fruit puree pouch for a snack.

The pouch, packaged in cartoon branding for the Trolls movie, was hand sanitizer that Teixeira purchased for her 7-year-old stepdaughter.

"I had been shopping with my husband... and they had these hand sanitizers in the middle aisle packaged in cute packages and I had a 7-year-old stepdaughter going back to school and I thought that'd be perfect for her backpack," Teixeira told ABC News' Good Morning America. "The way it was packaged and displayed with hand sanitizers, I didn't even think of it looking like a food."

When her stepdaughter said she already had sanitizer for school, Teixeira threw it in her own bag, which Logan does not have access to.

Logan's grandmother, though, had the bag on the day that she cared for him, and handed him the pouch thinking it was a snack that Teixeira, her daughter, had packed.

"He took a sip and immediately turned red and started coughing, so she grabbed it from him and then immediately saw it was hand sanitizer," she said. "She called her neighbor and called 911 because he started to get a little bit dozy and out of it, and then five minutes later he was falling asleep."

Teixeira said that by the time paramedics arrived minutes later, Logan was alert but he was taken by ambulance to a local hospital as a precaution.

The toddler did not sustain any medical complications from ingesting the hand sanitizer, according to Teixeira, who said her son's only lingering symptoms were that he was irritable and had little appetite for the rest of the day.

She shared her experience on Facebook in an effort to warn other parents and caregivers.

"Please *SHARE* with as many people as possible to raise awareness as schools are reopening soon and the hand sanitizers will be in circulation," Teixeira wrote on the post, which has now been shared hundreds of times.

"The way that it's positioned in the aisle made it easy to buy and it's alluring and cute," Teixeira told GMA. "I don't want it to happen to anybody else."

Not long after Teixeira posted on Facebook, the company that makes the hand sanitizer, sold under the brand Smart Care, announced it had removed the product from store shelves.

"We were recently made aware of a concern expressed by a parent regarding our hand sanitizer sold in a 0.84-ounce pouch. We took this concern seriously and immediately removed the product from retail," a spokesperson for the company, Ashtel Studios, told ABC News in a statement. "As safety is our No. 1 priority, we have switched out this packaging for our bottled hand sanitizer to eliminate any misconception or concern. We regret any inconvenience this may have caused."

Teixeira's warning to caregivers comes as the U.S. Food and Drug Administration (FDA) is also warning consumers about hand sanitizers that are packaged in everything from children's food pouches to beer cans, water bottles and juice bottles.

"I am increasingly concerned about hand sanitizer being packaged to appear to be consumable products, such as baby food or beverages. These products could confuse consumers into accidentally ingesting a potentially deadly product. It's dangerous to add scents with food flavors to hand sanitizers which children could think smells like food, eat and get alcohol poisoning," FDA Commissioner Stephen M. Hahn, M.D., said in a statement last month. "Manufacturers should be vigilant about packaging and marketing their hand sanitizers in food or drink packages in an effort to mitigate any potential inadvertent use by consumers. The FDA continues to monitor these products and we'll take appropriate actions as needed to protect the health of Americans."

In its warning to consumers, the FDA noted that hand sanitizer can be toxic when ingested, and shared other complications that may occur when hand sanitizer is misused.

"The FDA continues to see an increasing number of adverse events with hand sanitizer ingestion, including cardiac effects, effects on the central nervous system, hospitalizations and death, primarily reported to poison control centers and state departments of health," the agency said in a news release.

Throughout the coronavirus pandemic, which has spiked the sales of hand sanitizer, the FDA has also warned consumers about hand sanitizers that may contain methanol, a colorless liquid that can be absorbed into the body through inhalation, ingestion, skin contact or eye contact, according to the Centers for Disease Control and Prevention (CDC).

The FDA now lists at least 75 different brands of hand sanitizer to avoid.

Washing hands with soap and water is always preferred over the use of hand sanitizers, according to the American Association of Poison Control Centers (AAPCC).

When alcohol-based hand sanitizer is used, it should contain at least 60% alcohol, according to the AAPCC.

Hand sanitizer should always be applied to children's hands by an adult and should always be stored away and out of sight of children after each use, according to the AAPCC.

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sshepard/iStockBY: DR. DAVE HARRISON AND SONY SALZMAN, ABC NEWS

(WASHINGTON) — On Friday, the CDC updated its website to acknowledge that airborne transmission of the coronavirus beyond six feet may play a role in the COVID-19 pandemic, particularly indoors. The update was hailed by infectious disease experts interviewed by ABC as an overdue step.

But on Monday morning, the agency took down that language, saying it was posted in "error." Despite the CDC guidance whiplash, experts say it's time to recognize that airborne transmission beyond six feet is possible -- while continuing to emphasize that close contact within six feet is still the main way the virus is transmitted.

Scientists maintain that close, person-to-person contact is a main driver of the virus' spread. This transmission is primarily via respiratory droplets or small particles produced when an infected person coughs, sneezes, sings, talks or breathes in close proximity to someone else.

However, evidence is mounting that the virus can linger in the air, or travel distances greater than six feet -- what scientists call “airborne particles” rather than larger droplets -- especially indoors or in poorly ventilated areas.

Before it was taken down, the new CDC language described "growing evidence that droplets and airborne particles can remain suspended in the air and be breathed in by others, and travel distances beyond 6 feet (for example, during choir practice, in restaurants, or in fitness classes),” and that the risk was greatest indoors, with poor ventilation.

When the CDC briefly published its update regarding airborne transmission, experts initially expressed their support of this development.

"Although there was more data in the last three months pointing out that this airborne transmission is important, we have known that all these SARS type of viruses are indeed transmitted via airborne, going back to MERS and SARS Co-1,” says Dr. Rajat Mittal, professor in the Department of Mechanical Engineering and an expert in computational fluid dynamics at Johns Hopkins University.

"There’s been a lot of discussion about more distant transmission than 6 feet, and the question has always been, how important is that?" said Dr. William Schaffner, Professor of Preventive Medicine in the Department of Health Policy, Nashville, Tennessee.

This idea that the virus can be passed at distances of greater that six feet is anything but new. As far back as in March, up to 87% of attendees at a choir practice in Washington State were linked to one symptomatic patient, as an early example of a "super spreader event." Although the people at the choir practice took some social distancing precautions, singing loudly in an enclosed room may have contributed to infections.

In July, the World Health Organization updated its guidance to reflect these enhanced precautions. Many experts argue that the CDC should do the same.

Also in July, a panel of 239 scientists wrote a statement recognizing the risks of airborne spread as it relates to COVID-19, with an enhanced focus on indoor ventilation and continued emphasis on avoidance of overcrowding.

The difference between “airborne particles” and “droplets” is subtle, but important, experts say. Airborne particles are too small to see, and can accumulate over time in poorly ventilated areas.

Despite these new developments, nothing has changed about the virus itself and the precautions each individual needs to take to minimize the spread.

“Masks are still our number one line of defense,” said Dr. Mittal.

"If you’re indoors, keep the mask on," said Dr. Schaffner. "Don’t look for excuses to take the mask off."

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sshepard/iStockBy ANNE FLAHERTY, ABC News

(ATLANTA) -- The Centers for Disease Control and Prevention said Monday that it made a mistake when it posted new guidance online citing “growing evidence” that COVID-19 is airborne, sending health experts and the public scrambling to determine if schools and business should rethink mitigation steps to prevent the spread of the virus.

The misstep is one of several in recent weeks in which the CDC has left the public scratching its head.

Since July, the agency has flip-flopped on its guidance on testing people who don’t show symptoms, finally settling on the recommendation that it’s a good idea.

Critics of the Trump administration say too much politics is at play and that the agency’s wavering is undermining its credibility with the public.

“A draft version of proposed changes to these recommendations was posted in error to the agency’s official website. CDC is currently updating its recommendations regarding airborne transmission of SARS-CoV-2 (the virus that causes COVID-19). Once this process has been completed, the update language will be posted,” the CDC stated Monday.

How long the virus lingers in the air and how far it travels after someone sneezes or coughs has been the subject of much speculation since the beginning of the pandemic. On Friday, the CDC quietly updated a page on its website on how the virus spreads.

“There is growing evidence that droplets and airborne particles can remain suspended in the air and be breathed in by others, and travel distances beyond 6 feet (for example, during choir practice, in restaurants, or in fitness classes). In general, indoor environments without good ventilation increase this risk,” the CDC stated on Friday in a post that has since been taken down.

That assessment raised serious questions about whether such practices as attending school or dining indoors were safe because people would might remove their masks if there is enough social distance. School districts have long been sounding the alarm on the lack of ventilation, including old buildings and windows that won’t open.

But soon after the CDC change was noticed by media outlets, the CDC removed the posting. It remains unclear what CDC might post, if anything, on the matter. The White House task force on coronavirus stopped holding regular briefings on the pandemic, and CDC does not host press conferences.

The CDC caused alarm last August when it released guidance suggesting people didn’t necessarily need to get tested for the virus even if they were exposed. The agency last week walked that back and returned to its guidance from earlier in the summer that anyone who has been exposed needs to be tested.

Similarly, President Donald Trump last week insisted the agency’s director, Robert Redfield, made a “mistake” when he predicted that most Americans wouldn’t have access to a vaccine until the middle of next year.

Redfield’s spokesman initially issued a statement that appeared to realign himself with the president, but then retracted the statement, leaving it unclear whether Redfield agreed with the president.

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By DR. LEAH CROLL and DR. ALEXIS E. CARRINGTON, ABC News

narvikk/iStock(NEW YORK) -- Public health experts have proposed a national COVID-19 strategy based on the Obama administration's HIV/AIDS strategy.

In a newly published paper in the AIDS and Behavior journal, experts from multiple universities in the United States used the structure of the 2010 and 2015 National HIV/AIDS Strategy documents to suggest what a strategy for fighting COVID-19 should look like. These experts include prominent professors of public health and epidemiology, all of whom have worked with the CDC on prior epidemics.

A national strategy, they say, should be transparent, comprehensive and science-driven.

The National HIV/AIDS Strategy was launched by the Obama administration in 2010 and, according to the CDC, was the first-ever comprehensive coordinated HIV/AIDS roadmap; the five-year plan detailed principles, priorities and actions to guide a national response to the HIV epidemic. The strategy was updated in 2015 to include the emergence of treatments, pre-exposure prophylaxis, the implementation of the Affordable Care Act and other updates.

One of the study's authors, Dr. David Holtgrave, Dean of the School of Public Health of the University at Albany, State University of New York, said that with public health stakes so high right now, “it is really important to have a comprehensive plan for the nation in place as quickly as possible. And that plan should be one that’s comprehensive and also rooted in the best evidence and science that we possibly can use.”

The HIV/AIDS Strategy was a good starting point for drafting a COVID-19 plan because “it put in one place plans for prevention and treatment and addressing disparities and also coordinating services between the federal government, the state and local governments, and the private sector too,” he said.

Notably, President Trump pledged to end AIDS in the U.S. by 2030 in his 2019 State of the Union Address. However, “the current administration's plan to ‘End the HIV Epidemic’ addresses important core elements, but the strategy is less comprehensive than the early National HIV/AIDS Strategy,” said Holtgrave. “For that reason, we built upon the 2010 and 2015 update of the NHAS.”

The strategies presented for nationwide management of HIV/AIDS were rooted in scientific evidence and included thoroughly studied measures for disease prevention and medications proven to be efficacious for HIV/AIDS. In addition, the strategies addressed health disparities such as social and racial groups disproportionately affected by HIV/AIDS.

"Unfettered access" to high-quality treatment


However, HIV/AIDS and COVID aren’t totally torn from the same cloth. “HIV is very different than COVID, so clearly you can’t apply exactly the same interventions,” says Dr. John Brownstein, ABC News Contributor, Chief Innovation Officer and Professor at Harvard Medical School. “But similar non-pharmaceutical interventions can play a big role [with COVID]. Similar to HIV, disparities are playing such a big role in who is impacted, and education is a big component as well.”

The proposed COVID-19 strategy even includes a mission statement inspired by the National HIV/AIDS Strategy manifesto: “The United States will become a place where new SARS-CoV-2 infections are rare, and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”

Holtgrave details what is needed to be truly comprehensive in strategizing: looking into the patterns of COVID, utilizing evidence-based treatment and preventive measures (not only for acute infections, but for long-term effects too), coordinating services on multiple levels of government, addressing racial and ethnic disparities, establishing transparent metrics for progress.

“I think now when we hear discussions about where we’re going as a nation to address COVID, the discussions tend to be kind of piecemeal," he said. "They’re either focused on vaccines or maybe treatment or a bit on masks. We need to really be truly comprehensive.”

Holtgrave added that "there’s a clear role here for the federal government to develop a comprehensive national COVID strategy. If that doesn’t come from the federal government, then we need to have some other locus of energy around that. One challenge is finding who the group of people is that could come together, develop this further, and move it forward.”

Currently strategy is a "whack-a-mole" approach


Although it isn’t certain which framework would be ideal, as the pandemic continues to affect American communities, an evidenced-based national strategy to treat, prevent and manage COVID-19 seems more and more necessary. “The lack of a national strategy has created so much confusion, has created a patchwork of response and led to this ‘whack-a-mole’ and uneven control strategy,” said Dr. Brownstein.

“The concept of creating a transparent process which brings in the right voices to help determine a strategy is what we needed all along. So, if we can leverage an example of this, having done it before, to get us a few steps ahead, then that’s fantastic,” says Brownstein.

Leah Croll, M.D., is a neurology resident at NYU Langone Health and Alexis E. Carrington, M.D., is a dermatology research fellow at the University of California, Davis. Both are contributors to the ABC News Medical Unit.


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martin-dm/iStockBy CATHERINE THORBECKE and ALEXANDRA LAMBERT, ABC News

(NEW YORK) -- As the daily headlines and mounting death tolls sow widespread anxiety among a population grappling with the coronavirus pandemic, many businesses and others have sought to ease fears through a newfound and costly obsession with deep cleaning and sanitizing.

The pandemic-era trend of publicly exhibiting all sanitation efforts has taken both the private and public sector by storm, but some medical experts express concern that these surface-cleaning endeavors may not be the most effective means of combatting the spread of the respiratory virus.

Hotels in California proudly display their $100,000 UV disinfecting robots. United Airlines similarly announced it was using high-tech antimicrobial-spraying robots on some aircrafts to ensure the "deepest cleanings." United noted that it was a complementary technology used in combination with masks and other measures.

The New York City subway system, which operates around the clock, announced nighttime closures for the first time in its history in order to disinfect train cars, a move that comes with an estimated additional price tag of $500 million in 2020 alone. That price tag includes a small portion for protective gear and temperatures checks for employees.

The often-overlooked sanitizing industry has boomed. Stock for Clorox reached a new all-time high last month, and has spiked some 35% in 2020. And a slew of private firms and startups touting disinfecting wands and other gadgets have also reported skyrocketing spikes in interest.

The public-facing displays of disinfecting efforts by companies have been dubbed "hygiene theater" in a recent The Atlantic article, which equated the showy presentations to the post-9/11 "security theater" phenomena, an endeavor that was slammed for focusing more on quelling people’s worries rather than actions that actually emphasized safety.

Is there a 'danger' in so-called hygiene theater?

Dr. Emanuel Goldman, a microbiology professor at Rutgers University and co-editor of the Practical Handbook of Microbiology, warned in a commentary published in the medical journal Lancet in July that the risk of catching COVID-19 from a surface has been "exaggerated" and became one of the major voices raising concerns over misdirecting resources to so-called "hygiene theater."

Goldman told ABC News that the "danger" of hygiene theater is that "it changes the focus from what will really protect you, and that is protecting what you breathe."

Obsessive cleaning in a pandemic is not necessarily a bad thing, Goldman clarified, especially for high-touch, high-traffic locations such as grocery store checkout lanes.

"When you start applying this strategy to the New York City subways for example, public school systems, then it’s starting to be a bad thing, because it's wasting limited resources," he said. "In the case of the New York City subways, it's not only a huge hit on their budget, it’s also a tremendous inconvenience on their transportation system to be shut down every night."

Earlier this week, the New York Metropolitan Transportation Authority, the agency that runs the subway, issued a desperate plea for $12 billion in federal funding, warning that without it, all supplier contracts are in jeopardy.

Ken Lovett, a senior advisor to the chairman and CEO at the MTA, told ABC News in a statement that the MTA "resolved to do everything we could to keep our customers and heroic employees safe, and we continue to do that with round-the-clock cleaning and disinfecting of stations and rolling stock, piloting new methods like UV lights, anti-microbials and electrostatic sprayers, and requiring everyone in the system wear masks."

"Even while the subway fresh air exchange far exceeds the minimum rates required by the CDC for certain health care facilities and restaurants, we are tackling the aerosol issue by bringing new technologies to address the issue through the COVID Challenge and we will continue to respond in real-time to do everything we can to keep our customers safe," he added.

Goldman said that he also received an email recently from a teacher who read his research and told him her school board was planning on shutting the schools down one day a week for "deep cleaning."

"They have limited resources, that’s going to cost a lot of money, that’s going to cost time," he said. "I wrote the school board for her and miraculously, they listened to me, and redirected their budget to ventilation systems, because breathing is where you catch this disease."

Ultimately, high tech and pricey sanitizing equipment is not necessary in most cases, according to Goldman.

"Soap and water kills COVID," he said. "Ordinary alcohol kills COVID."

Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital, told ABC News that so-called hygiene theater can be "really important" in certain circumstances -- such as healthcare settings or places where high-risk individuals live or work, where he says, "we want to do everything as much as possible to reduce transmission."

He added, however, that "these kinds of interventions are not absolutely appropriate for every setting."

What is the risk of catching COVID-19 from a surface?

Brownstein explained to ABC News that there was a "theoretical risk" that you could catch COVID-19 from a surface, but it is "probably not the predominant mode of transmission."

The U.S. Centers for Disease Control and Prevention states that "it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn’t thought to be the main way the virus spreads."

The international World Health Organization says that fomite transmission is "considered a likely mode of transmission" for COVID-19, but adds that despite evidence that the virus can survive on surfaces, "there are no specific reports which have directly demonstrated fomite transmission."

The U.N. health agency also noted that people who come in contact with potentially infectious surfaces often also have close contact with an infected person, making distinctions between respiratory droplet and fomite transmission difficult to discern.

While there have been studies conducted in the past that show COVID-19 can live on surfaces, Goldman said that in real-world scenarios outside of a lab he found evidence of surface (or fomite) transmission of the virus "to be extremely weak."

"A lot of steps have to happen before you would get transmission of the virus from a surface," Goldman told ABC News. "First, you would have to have someone infected cough or sneeze on that surface. Next, you would have to have the individual touch that surface within I would say within the hour or two, and then without washing their hands in between touch their faces, mouth, ears or eyes."

He added that there is then a "presumed risk" of catching the virus that way.

"I don’t want to misinform people," he added. "Hand-washing is still important. Proper hygiene is still important. That would be important even if there was no pandemic -- That’s what we should be doing anyways."

If not obsessive surface cleaning, where should efforts be focused?

Brownstein said that one of his biggest concerns with hygiene theater is that "it's just not sustainable."

"We’re asking the population and industry to do a lot and at some point there is going to be pandemic fatigue," he added.

He noted that the more experts attempt to enforce these sorts of efforts around a theoretical risk, "the more chance people are just going to, basically, not want to implement them."

"We know that things like mask-wearing is so critical, let’s focus on the handful of issues that we know are driving those transmissions," he added.

Similarly, Goldman told ABC News that, "the most important things that can be done is to wear a mask."

While hygiene theater has been largely welcomed by an anxious public, mask-wearing, what experts say is one of the best lines of defense against the spread, has become a flashpoint in the U.S.

Besides strict adherence to mask-wearing, both experts said social distancing, moving indoor activities outdoors, and improving ventilation systems are key for combatting the virus' spread.

Finally, Goldman said if you are entering a store or restaurant or elsewhere, don't look first to their hygiene theater routine for assurance. Rather, he recommends checking out if all of the workers and people are wearing masks, what socially-distancing measures are being implemented and even asking about ventilation efforts.

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grejak/iStockBy STEPHANIE EBBS and ANNE FLAHERTY, ABC News

(ATLANTA) -- The Centers for Disease Control and Prevention has reversed guidance on who should be tested for the virus that causes COVID-19, specifying that asymptomatic people who have come in contact with an infected person should get tested and quarantine for 14 days -- a change from guidance released last month that said testing might not be necessary for people without symptoms.

CDC guidance released in August caused alarm in the public health community that data would give an incomplete picture of outbreaks around the country, and The New York Times reported this week that it was published by the Department of Health and Human Services without approval from experts at the CDC.

It said that if a person came in contact with someone infected with the virus that causes COVID-19 "you do not necessarily need a test" if you don't exhibit any symptoms, but that local public health officials or health care providers might still recommend one. CDC Director Robert Redfield has tried to clarify the guidance, testifying this week that it did not mean people without symptoms shouldn't get a test but that they should consult local health guidance and that testing should be paired with other protective measures like isolating for 14 days.

The CDC removed that language on Friday, returning to instructions that say if someone has been in close contact with a person with COVID-19 infection "you need a test" and to self-isolate for 14 days, even if the test is negative.

Doctors like Thomas File, president of the Infectious Diseases Society of America, praised the reversal and called it a return to science-based decisions.

“The return to a science-based approach to testing guidance from the Centers for Disease Control and Prevention is good news for public health and for our united fight against this pandemic. We urge officials to support the work of controlling this pandemic by following medical guidance of experts in the field," File said in a statement.

This week, The New York Times reported the August guidance was pushed by officials at the Department of Health and Human Service and White House coronavirus task force over the objections of experts at CDC. But Brett Giroir, the top official at the Department of Health and Human Services leading the federal efforts on testing, pushed back on that report.

“This was a CDC document and we will continue to clarify because I want people to know that if you are asymptomatic you can still spread the virus and we want them to be tested,” he said in an interview on ABC's "Good Morning America" on Friday.

Public health officials say that a lack of testing has been a weak point in the country's response to the coronavirus pandemic since the beginning, from a lack of tests to backlogs for results, making it more difficult to trace who infected people have been in contact with.

President Donald Trump has said that more tests result in more cases, causing concern among public health experts that he could push to slow testing they say is crucial to tracking outbreaks around the country.

He has also publicly contradicted officials working on the COVID-19 response on the timeline for a potential vaccine and the effectiveness of wearing face masks, which officials at the CDC and HHS say is the most important tool in preventing the spread of the virus.

Public health experts have expressed concerns that political considerations are influencing the pandemic response and have bristled at reports that political appointees are overruling subject matter experts at the CDC and the FDA.

A top official at Health and Human Services, Michael Caputo, recently announced he was taking leave after he made comments on social media accusing CDC scientists of sedition and saying they don't care about protecting Americans, charges the CDC director and other public health officials denied. Caputo later apologized.

Officials in the Trump administration have said they were not directed to slow testing and are distributing more testing equipment to nursing homes and other vulnerable populations to help track and stop infections.

"The number of cases are going to be the number of cases; we do more testing so we can detect more and more cases. That's a good thing. We want to detect as many cases as we can...It is true that the more testing you do, the more cases you will discover. But the cases are there no, no matter what," Giroir testified at a Senate Appropriations Committee hearing on Wednesday.

Any appearance of political influence could be particularly harmful when it comes to a potential COVID-19 vaccine, experts warn. The concern is that people will decide not get vaccinated and that the virus will continue to spread.

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By KATIE KINDELAN, ABC News

Hailshadow/iStock(NEW YORK) -- Olympic gold-medal-winning figure skater Tara Lipinski is opening up about undergoing endometriosis surgery in hopes of breaking down barriers around the condition that affects millions of women.

"The irony of my endometriosis diagnosis is that I knew almost nothing about a disorder that affects one in 10 women. That’s 176 million people," Lipinski shared on Instagram. "I’d never heard another woman mention 'endo' or the complications and pain that accompany it. And that definitely shows the lack of information that’s out there and the comfort level that affected women have discussing their endometriosis."

"To me, it feels like a hush hush topic that women feel they just need to tough out," the 38-year-old wrote. "No woman should live in pain or think 'this is just something I have to deal with.'"

Endometriosis, a medical condition whereby the lining of the uterus grows outside of the uterus, may affect more than 11 percent of American women between the ages of 15 and 44, according to the U.S. Department of Health and Human Services Office on Women's Health (OWH).

Lipinski said she had “intermittent pain” for years that she overlooked and didn’t discuss completely with her doctors.

“Over the last five years the pain progressed, but because it wasn’t constant or startlingly intense, I just chose to ignore it,” she wrote. “I figured that since I didn’t have crippling pain and it wasn’t significantly impacting my life, I could just block out my concern.”

When the pain became more intense this year, Lipinski said she started researching endometriosis and then found a surgeon who was able to help, writing, “I think that might be the biggest obstacle of endo care -- finding a surgeon who knows exactly how to navigate this complicated disease.”

After studying her options, Lipinski said she chose to have an “excision procedure, that uses robotic scissors to cute the endo from the places where it exists.”

Calling herself “one of the lucky ones,” the California-based Lipinski described her surgery as a success, noting that “pretty much 100 percent” of her endometriosis was removed.

“After a week or so I began to forget I had the surgery until I’d look down at the battle wounds across my stomach,” she wrote. “It felt so good to finally have a diagnosis.”

What is endometriosis?


Endometriosis strikes when endometrial tissue, the tissue that lines the uterus, grows outside of the uterus and onto other areas of the body, like the ovaries, fallopian tubes, vagina and cervix, according to the U.S. Office on Women's Health.

The cause of endometriosis is unknown but its symptoms are well-known: Painful menstrual cramps, chronic lower back and pelvis pain, pain during and after sex, bleeding or spotting between periods and digestive problems like diarrhea, constipation, bloating and nausea. These symptoms are most often experienced during menstruation.

Endometriosis also makes it harder for women to get pregnant.

Any girl or woman who has menstrual periods is vulnerable to endometriosis. It is more common, however, in women ages 25 to 35.

There is no known cure for endometriosis. There are several treatment options, including birth control and other hormonal treatments, and a medication, Orilissa, specifically studied and marketed for the treatment of endometriosis pain.

Another treatment option is laparoscopic excision surgery, where doctors remove scar tissue and growths, according to Dr. Tamer Seckin, a New York-based endometriosis specialist who co-founded the Endometriosis Foundation of America (EFA) with actress Padma Lakshmi.

What women need to know


Many women wait as long as 10 years for an endometriosis diagnosis, according to the EFA.

That is not to say though that women who take years to be diagnosed are not advocating for themselves at every point in the journey. It's quite the opposite.

"Today’s women are exceptionally educated on this," said Seckin.

Seckin's advice for female patients is to track their symptoms diligently and to note, in particular, where the symptoms fall in relation to their menstrual cycle.

Symptoms of endometriosis, like cramping and digestive issues, are often misdiagnosed as Crohn's disease or irritable bowel syndrome when doctors don't ask if the pain is associated with the patient's period, Seckin noted.

Women should also know that they should not be suffering in silence, according to Seckin. He shared six symptoms that women should watch for -- not because they mean a woman automatically has endometriosis, but because women should not have to live with pain.

These symptoms are most commonly found during menstruation, when the tissue is the most inflamed.

1. With periods, any pain that lasts beyond two days is not normal.
2. Any pain that sends them into the fetal position, even for just one day, is not normal.
3. Any pain associated with vomiting or severe GI disturbance is not normal.
4. Pain during deep [sexual] contact, deep penetration is not normal.
5. If you have pain around bowel movements or get constipated during your period, that’s not normal.
6. Increased gas and bloating associated with your period is not normal.

Most important, according to Seckin, is to find a doctor whom you trust.

"If women tell their doctors [their symptoms] and their doctors’ eyes don’t lock on them, find another doctor," he said. "There are doctors who are interested in endometriosis."

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Rattankun Thongbun/iStockBy DR. LEAH CROLL, ABC News

(NEW YORK) -- As America waits for a COVID-19 vaccine, the Centers for Disease Control and Prevention's director, Robert Redfield, said we all might be better protected by simply continuing to wear masks. His comments drew criticism from President Donald Trump, who is touting the pending vaccine as a panacea for the pandemic.

"I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine," said Redfield, in testimony given to the Senate Appropriations Committee on Wednesday.

But later Wednesday, Trump said Redfield was "confused" and mistaken when he spoke about the importance of wearing masks. It was not the first time Trump has cast doubt on the CDC's mask recommendations. At an ABC News town hall Tuesday, he claimed, "There are a lot of people that think that masks are not good."

But five experts interviewed by ABC News all agreed with Redfield, saying that masks are, in fact, our strongest weapons against the pandemic.

During his Senate testimony, Redfield explained that a vaccine might not be 100% effective at producing an immune response strong enough to stave off infection. Masks, however, provide an evidence-backed protective barrier.

"I agree with Dr. Redfield. At best, a vaccine will be about 75% effective against moderate to severe disease," Dr. Paul Offit, a professor of pediatrics at Children's Hospital of Philadelphia and a co-inventor of the rotavirus vaccine, told ABC News. "A mask, on the other hand, if used correctly and combined with social distancing, will be far more effective than that."

Dr. Paul Goepfert, director of the University of Alabama at Birmingham Vaccine Research Clinic, said, "I think the confusion here is that we do not know the efficacy of the COVID vaccines yet, nor how quickly available they will be if found to be effective, nor the percent of the population willing to get the vaccine. Since we do not know any of that yet, masks are a better solution."

The physical barrier that masks provide eliminates the ability of the virus to move from person to person, Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins University Center for Health Security, said. This means that if masks are implemented widely and consistently, they will dampen the spread of COVID-19 significantly.

"The first-generation COVID vaccines are not expected to render all vaccines impervious to infection -- as they won't be like the current measles vaccine -- but to modify illness so that severity and need for hospitalization is lower. So, even among the vaccinated, there will still be infections that occur, they will just be less frequent and less severe," he said.

Still, public health experts stress that vaccines are indeed essential for fighting off the pandemic, even if we don't know how effective they will be yet.

"An effective vaccine that is readily available and utilized by the majority of the population is the single best method that humans have developed to prevent disease -- other than providing clean water," said Goepfert.

However, "Based on the current information about COVID-19, we know that wearing a mask is very effective in slowing the spread of the disease," said Dr. Simone Wildes, an infectious disease specialist at South Shore Health and an ABC News Medical Unit contributor.

While we wait to learn more about COVID-19 vaccine efficacy and distribution, "both measures will be equally important," she added.

"The bottom line is we don't know what is more effective without data about the Phase 3 of the vaccine trials," said Dr. John Brownstein, an ABC News contributor and epidemiologist at Boston Children's Hospital.

"Without that information, we must still consider masks one of our most important currently available public health interventions," Brownstein said. "When a vaccine does become available, we should not consider this an either/or, but the synergy of two innovations creating the best possible combination of disease protection."

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Lauryn WebbBy ABC News

(NEW YORK) -- A year-old boy from Virginia was given a very special gift this week: the ability to hear his mother’s voice.

Maison McMillian, of Richmond, sat on his mother Lauryn Webb’s lap as he was fitted for hearing aids at VCU Children’s Hospital.

“Hi! Can you hear me? Hi baby,” Webb said to Maison in a moment caught on video. Maison’s face immediately lit up with a smile and he cooed back to his mother.

Webb took to Twitter to share the heartwarming moment. The video has since gone viral with 4.3 million views.

Maison, who weight only a pound when he was born four months premature, has had to overcome a lot in the past year, said Webb. Maison spent 158 days in the neonatal intensive care unit after his family and doctors began to realize he could not hear them.

my baby got his hearing aids today. look at his face 🥺😭 pic.twitter.com/IwwdsQVrSN

— finessa hudgins (@lil_lopeep) September 16, 2020

“Maison you are nothing short of a miracle. A year ago, when I had you, I was scared you came out so small -- not even two pounds. Maison Martin you are the strongest, bravest person I know and I thank God everyday for choosing me to be your mommy,” Webb said in an Instagram post for Maison’s first birthday.

“I love you beyond words Maison. Here’s to the first year of our journey being complete, but the first day of our next journey,” she added.

The family is now happily home and smiling together. Webb told ABC News' World News Tonight that the family was glad the video was able to bring joy to so many people.

“Maison is so thrilled to be able to hear everything now,” she said. “He just can’t take his eyes off of whoever is speaking. We’re just so glad that everybody else can gain some happiness from the video just like we did, and brighten up some people’s days during quarantine.”

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jfmdesign/iStockBy KELLY MCCARTHY, ABC News

(NEW YORK) -- Clorox wipes are still in short supply due to increased demand as Americans continue to clean off frequently used surfaces to combat the spread of coronavirus, but another household cleaner has been added to the list of effective products.

Pine-Sol Original Multi-Surface Cleaner received approval from the U.S. Environmental Protection Agency (EPA) "for kill claims against SARS-Cov-2, the virus that causes COVID-19, on hard non-porous surfaces," the Clorox Company announced in a press release about its cleaning product.

After testing from a third-party laboratory, the disinfectant was proven effective against the virus with a "10-minute contact time on hard non-porous surfaces."

The EPA advises that when using any of the registered disinfectants on its list to follow all label directions "for safe, effective use," which includes the amount of time the surface should be visibly wet with the product.

Chris Hyder, vice president and general manager of the cleaning division at The Clorox Company said in a statement that they hope the new approval will "increase access to disinfectants that can help prevent the spread of COVID-19."

Check out the full list of products that meet EPA’s criteria for use against the COVID-19 virus here.


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Bill Oxford/iStockBy PRIYA AMIN, ABC News

(NEW YORK) -- Nine months into the global pandemic, scientists are still piecing together the mystery of the first crossover event, in which the coronavirus moved from bats to an intermediary animal and, eventually, to humans.

By comparing the patterns of mutations from the new coronavirus to other known viruses, researchers have been able to create an evolutionary history of the related viruses, and found a "single lineage responsible for the COVID-19 pandemic." Surprisingly, they also found that the closest known ancestor of the SARS-CoV-2 virus has actually been living in bats for 40-70 years.

"While the new virus looks like coronaviruses that circulate naturally, it's unique in ways we didn't know about before the pandemic," said Dr. David Robertson, head of viral genomics and bioinformatics at the Institute of Infection, Immunity and Inflammation at the University of Glasgow.

Robertson and his team study how coronaviruses recombine in identifiable ways, which allows them to study the evolution of the SARS-CoV-2 virus. Scientists still aren't sure what happened in between bats and humans, but they say it's likely the virus circulated for a while in a pangolin or another intermediary animal.

Despite some lingering questions about how and when the virus made its journey from bats to humans, Robertson said his research on the virus' genetic code proves beyond a shadow of a doubt that the virus came from nature, and that by studying the virus' origin, we can better prepare for the next pandemic.

According to their recent study, which is awaiting peer review, humans are almost the perfect hosts for SARS-CoV-2, as the virus has "apparently required no significant adaptation to humans since the start of the COVID-19 pandemic." As a result, the virus naturally evolved in bats and was almost immediately ready to be spread through human contact.

"As part of our understanding of how this virus emerged, where it emerged from and what took place, this study adds an important component to an evolving story," said Dr. John Brownstein, the chief innovation officer at Boston Children's Hospital and an ABC News contributor.

"It shows it wasn't some big recombination of viruses that led to the pandemic -- it was actually a virus that had been circulating for a long while in bat populations that had properties that were conducive to human infection," he added.

"If it had been made in a lab, it would have looked like viruses we already knew about, more closely related to the SARS virus," he said.

Yet, conspiracy theories about the virus' origins persist. In the most recent example, an anti-Chinese government group linked to Steve Bannon published a swiftly rebuked paper alleging that "laboratory manipulation is part of the history of SARS-CoV-2." The paper makes a number of bold accusations, including that the virus was made in a lab controlled by the Chinese government. Virology experts widely agree, however, that none of the authors' claims can be supported.

"There is nothing in this document that supports the idea that it is man-made," said Stanley Perlman, M.D., Ph. D., a professor at the department of microbiology and immunology, and the department of pediatrics at the University of Iowa.

"In addition, no one would have known how to construct a pathogenic virus, and too little is known to predict pathogenicity," Perlman said.

"There is a great deal of experimental support, from multiple groups, on the natural origin of SARS-CoV-2," said Vincent Racaniello, Ph. D., a Higgins professor in the department of microbiology and immunology at Columbia University College of Physicians and Surgeons.

Animal-to-human transmission of viruses has been responsible for many diseases, like the bubonic plague or the West Nile virus, and have caused other recent outbreaks, such as the 2014-2016 Ebola outbreak and the global HIV/AIDS pandemic.

"This is a story that you have over and over again, where you have these viruses circulating in animal populations, and there is some moment where these viruses were able to infect someone," said Brownstein.

To prevent a future pandemic, scientists say our best bet is to better understand the link between animal populations and human populations.

"Landscape, fragmentation, climate change, transportation or illegal wildlife trade: All these factors are creating new interfaces for humans and animals. That probably was part of the reason for this pandemic," said Brownstein.

Having those scientific conversations will likely be the key to stopping a future pandemic -- next time, before it starts.

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Meyer & Meyer/iStockBy DR. ALEXANDRIA LAMBERT, ABC News

(NEW YORK) -- A growing chorus of experts is calling on Russian scientists to explain potential discrepancies in the data supporting the country's COVID-19 vaccine, dubbed Sputnik V.

Russia was the first country to authorize a COVID-19 vaccine, but it did so before completing proper scientific studies to show it is safe and effective.

Now, with questions about Russia's vaccine swirling, experts interviewed by ABC News expressed concern about the country's swift action to disseminate the unproven vaccine to low and middle-income countries, noting that if the vaccine were to prove a failure, it could fuel vaccine skepticism globally.

Russian scientists from the Gamaleya National Research Center published their findings of an early-stage study in the prestigious medical journal, The Lancet, on Sept. 4, showing that the vaccine was safe.

But molecular biologist Dr. Enrico Bucci said he quickly developed "several concerns" upon looking at the data. Bucci, who heads a science integrity company called Resis, in Italy, published an open letter on his blog about Russian's vaccine study. The letter quickly gained additional signatories, and on Sept. 7, the scientists submitted their formal complaint to The Lancet.

The letter highlighted data irregularities in the study that appear to be duplicated. It has now been signed by a total of 38 experts.

"We do not allege misconduct, we just want them to provide additional data," said Dr. Konstantin Andreev, one of the signatories and a microbiologist and biophysicist affiliated with the Howard Hughes Medical Institute and Northwestern University.

Another researcher who signed the open letter, Dr. Donald Thea, the director of the Center for Global Health & Development at the Boston University School of Public Health, said, "What we need to see is the data. Science is based on transparency and accuracy and precision -- even more when it comes to a global vaccine effort of such huge proportions and importance."

The Gamaleya National Research Center for Epidemiology and Microbiology did not respond to ABC News' request for comment.

Sputnik V has also not completed the large Phase 3 randomized control trials that are required in the United States and many other countries prior to vaccine approval. These studies traditionally compare the vaccine to a placebo in thousands of people to determine whether it works in preventing disease, and to further assess its safety profile.

"The thing is that they try to start distributing the vaccine even before completing Phase 3 clinical trials, and the Phase 1 and Phase 2 trials described contain only a very, very small number of patients, only 76 patients, [an] enormously small [amount] for such an important topic," said Andreev.

Russia was able to initially skip the Phase 3 clinical trials due to differences in international regulatory agencies.

As Russia prepares mass production of Sputnik V, there are significant global health implications to be considered. Although international scientists have warned that no one truly knows yet if the vaccine works, Russia is already accepting purchase orders from low and middle-income countries eager to obtain a coronavirus vaccine.

In a recent article in The Lancet, Kirill Dmitreiv, CEO of the Russian Direct Investment Fund, confirmed that Russia has received international requests for one billion doses of its vaccine.

Russia is talking to at least 20 countries about exporting the vaccine, including Brazil, Cuba, the Philippines and Saudi Arabia. If the vaccine is given to people before it's properly tested, however, the consequences could be catastrophic.

"If what we end up with is people in poor countries getting untested vaccines, first of all, ethically, that's a disaster," said Dr. Ashish Jha, the dean of Brown University's School of Public Health. "Second, it will have very long implications for the health of those people and their confidence in vaccines. So, I think it's critically important that we don't do this anywhere, but particularly we don't do it in low-income countries."

Other experts cautioned that the global distribution of an ineffective vaccine could promote vaccine hesitancy and create a false sense of security that could further propagate COVID-19 transmission.

"I'm hopeful that it will work, but if it doesn't, it will send huge mixed signals to the global community," Jha said.

"People will be very, very hesitant to take the COVID vaccine," he said, if the Russian vaccine ends up not working.

"If we are lucky, it will be, you know 70-80% effective," Jha said.

"They are going to think they are protected and they very well might get sick and then die from it," he added. "So, it is absolutely essential to figure out how effective it is and then communicate that to people. But the problem is, if you haven't tested it, you don't know how effective it is. And if you don't know how effective it is, you don't know what to tell people, and you're going to create this huge false sense of confidence that could be very, very dangerous."

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