ABC - Health News

juankphoto/iStockBy DR. MOLLY STOUT, ABC News

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

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

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

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

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

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

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

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

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

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

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

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

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

And the risk was cumulative.

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

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

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

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

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wragg/iStockBy ANGELINE JANE BERNABE and KATIE KINDELAN, ABC News

(NEW YORK) -- Living through a pandemic and quarantining can be a drag, but many are using this time to re-start their lives and prioritize their health.

With pre-existing conditions a contributing factor to contracting the novel coronavirus, 30-year-old Romelle Morris from New York City, said he was committed to making a life-saving change, especially since he had asthma and was overweight.

"It was a wake-up call," Morris told GMA. "Watching the news and seeing asthma was high risk, and seeing that obesity was high risk -- for me, it wasn't guaranteed that I was going to make it through this pandemic and it felt like COVID was going to put me at risk."

But Morris didn't face his health issues alone, and was able to get to work on his health journey with his partner, Darrin Rahn, who also had his own health goals at the beginning of the pandemic.

"I have always been heavy and struggled with my weight," Rahn told GMA. "When COVID happened in March and Romelle was like, let's focus on this, we have the time and energy."

So the couple got to work and followed what they call a holistic approach, which is focusing on diet, exercise and mental health.

They started with food like swapping out unhealthy snacks with fruits and veggies and incorporating more walks into their routine, making it a point to put their computers down at 6 p.m. each day to take a walk through the city.

"It was small little goals, small changes in eating and then layering on exercise and it was one change after another day by day," said Rahn.

And those small changes paid off for the couple, who has lost over 80 pounds combined in just five months.

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simon2579/iStockBy STEPHANIE EBBS and SONY SALZMAN, ABC News

(NEW YORK) -- Public health experts and scientists closest to the process of developing and testing vaccines for COVID-19 said they're confident the process is based in solid science, despite the perception that the Trump administration's "Operation Warp Speed" would rush the process to have a vaccine available before the election.

President Donald Trump has repeatedly contradicted public health officials in his administration on when a vaccine could be approved and available, often emphasizing how quickly it could be done. The White House announced Operation Warp Speed to help accelerate that process by working with manufacturers to produce doses of vaccines and materials needed to distribute them before the vaccines themselves are approved.

"At first I thought it was a good term," said Dr. Walter Orenstein, professor and associate director of the Emory Vaccine Center. Now, Orenstein said, "I think it has given people a perception that corners will be cut. To my knowledge, none of those corners are being cut."

But officials like Dr. Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases, said that just because the vaccine process is moving quickly doesn't mean they're cutting corners.

"The pace of it relates so much more to the technological advances of the platform technologies that are being used right now," he said during an event with Harvard University this week. "We truncated a lot of time. It has nothing to do with safety, we haven't even gone near a person yet. It was only the technological advances. Right now the FDA is not cutting corners, but they're doing things in a much more rapid, expedited way."

Scientists who are working on the various coronavirus vaccine candidates agreed, noting that the rapid pace of development is the result of a financial investment, rather than a scientific shortcut.

Developing a new vaccine is expensive. Traditionally, cost-conscious pharmaceutical companies move slowly, starting with a product in a so-called "Phase 1" of testing and ensuring it works before moving on to larger (and more expensive) Phase 2 and 3 trials.

Now, all those steps are happening simultaneously -- at great financial cost but not in a way that sacrifices the scientific integrity of the process.

"I think going very quickly doesn't necessarily translate into being rushed. Rushed has a conception of being sloppy. Moving quickly can be done by improving efficiency and downtime," said Dr. Dan Barouch, professor of medicine at Harvard Medical School, who is involved in Johnson & Johnson's vaccine effort.

"All these phases of clinical trials go through a huge amount of safety testing. None of those safety tests are being skipped," said Deborah Lynn Fuller, professor of microbiology at the University of Washington School of Medicine.

Meanwhile, companies are scaling up manufacturing before it's clear if the vaccines work -- many with the financial backing of Operation Warp Speed.

"The leading companies are starting to mass-produce vaccines now, even before there's any evidence of success," said Barouch. "If the vaccines fail, they will take millions of doses and discard them. ... That has never been done to the best of my knowledge in pharmaceutical history."

Democrats on committees with oversight of the federal coronavirus response and experts connected to the process have continued to press officials and ask questions about how they will respond to potential political interference.

Paul Offit, director of the Vaccine Education Center and a physician in the Division of Infectious Diseases at the Children's Hospital of Philadelphia, serves on the Food and Drug Administration's vaccine advisory committee that will be reviewing data on COVID-19 vaccines.

Offit said he's concerned the Trump administration could apply pressure to approve a vaccine that Operation Warp Speed has supported because millions of doses already exist, even if the data is still preliminary. He said even the appearance that decisions around vaccines are politically motivated could undermine confidence they are safe.

Twenty-seven percent of American adults said they wouldn't get vaccinated against COVID-19 if a vaccine is approved, according to a ABC News/Washington Post poll conducted in May. Half of those people said they don't trust vaccines in general.

Trump was asked this week if we could see a vaccine by Election Day this year and he said he's optimistic that could happen. When asked if it would benefit him in the election, Trump said, "it wouldn't hurt" but that isn't why he's pressing the agencies to move quickly.

"I'm doing it not for the election. I want it fast because I want to save a lot of lives," he told reporters at the White House on Thursday.

Public health experts in the administration, like Food and Drug Administration Commissioner Stephen Hahn, have repeatedly emphasized they won't cut any corners on a COVID-19 vaccine and that the FDA is following all its usual procedures to ensure a vaccine is safe and effective before it's made available. The FDA is an independent agency within the government and Hahn has said vaccines supported by Operation Warp Speed aren't receiving any special treatment.

"I have been asked repeatedly whether there has been any inappropriate pressure on the FDA to make decisions that are not based on good data and good science. I have repeatedly said that all FDA decisions have been, and will continue to be, based solely on good science and data. The public can count on that commitment," he wrote in a Washington Post op-ed on Wednesday.

A vaccine will only be authorized by the FDA once it has generated enough evidence it works in massive, late-stage trials that include 30,000 people. And Hahn has said the agency will consult with an advisory board of experts who are vetted for potential conflicts of interest.

If a vaccine is deemed safe and effective by the FDA based on the evidence generated from those trials, it will likely be given to frontline workers and other people who are particularly vulnerable to the virus before it's made widely available.

Even if a vaccine reports data from clinical trials and is approved by the FDA by later this year, Fauci recently testified it would be available to most Americans "over a period of time in 2021," based on how it is phased in and distributed.

Scientists working on the process to develop a vaccine also said they haven't seen any political influence on the process, and would be some of the first to raise the alarm if they did.

"The public perception is critically important," said Barouch, because if the public doesn't trust a vaccine, they are less likely to volunteer in large numbers for late-stage studies, and less likely to take a vaccine once it becomes available to the general public.

"That can make it tougher to recruit (for studies) because then people don't trust," said Dr. Arthur Caplan, director of the Division of Medical Ethics, New York University Grossman School of Medicine.

Like most scientists, Caplan is a big supporter of vaccines generally. He was one of the last children to develop polio in the United States before scientists successfully eradicated the disease with a mass vaccination campaign.

"I am nervous that if this thing isn't framed right, that we scare people by talking about speed," Caplan said.

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ABC NewsBy ANTHONY RIVAS, ABC News

(NEW YORK) -- Five former directors of the Centers for Disease Control and Prevention who came together to speak about the coronavirus on Thursday said repeatedly that the United States is still struggling to deal with the pandemic because of one thing: mixed messages from leadership.

"This is the first public health response where the ground rules weren't set up that we would be driven by the best available public health science," said Dr. Richard Besser, who served as acting director of the CDC in 2009. "So, when you have political leaders and public health leaders coming at this with very different messaging, [and] when you don't see the political leadership supporting public health science, you lose trust. And the people question whether things are being done because they're the right thing to do scientifically or whether they're being done for political reasons, and that leads to an undermining of the efforts to control something that is truly controllable."

Besser was joined by Drs. Julie Gerberding, Tom Frieden, Jeffrey Koplan and David Satcher to speak with ABC News' Linsey Davis. The former CDC directors, who worked under both Democratic and Republican administrations, also spoke about preventing the next pandemic and about the challenges Americans will face even once a vaccine is approved.

They said the country's best chance at stopping the virus is by working together.

"Right now, one person a minute is getting killed by this virus in the U.S., and we need to focus on what the virus is doing and what we as a community are doing to stop it," said Frieden, who was the CDC director from 2009 to 2017. "Because all of us can do things to make it less severe, whether that's wearing a mask, washing our hands, watching our distance or supporting public health so that they can box in virus… and protect the most vulnerable. There's a lot we can do. Progress is in our hands, but when it's undermined, it makes it very difficult to make progress."

"This pandemic is not something that's going to end abruptly," said Satcher, who was the CDC director from 1993 to 1998. "The problem is going to be with us for a while in terms of COVID, so the question becomes: When are we going to get on top of it? When people take seriously the challenge."

The U.S. death toll from COVID-19 is higher than anywhere else in the world with at least 159,000 deaths. Nearly five million Americans have been diagnosed with the virus. As 31 states see a rising number of daily deaths and 25 states see increasing rates of positive cases, President Donald Trump in recent weeks claimed the U.S. has the virus "under control" and that the country is in "really good shape."

"Every one of those falsehoods drives away our opportunity to improve our mitigation efforts… and it causes confusion in everyone's mind," said Koplan, who directed the CDC from 1998 to 2002.

He said that even when the information needs "sugarcoating or even if it's something that seems bad news and people will be upset, the truth is really what counts."

"Once you lose that edge, then you're behind not just the virus -- you're behind the public opinion and people's behavior," he added.

Besser noted that early in the pandemic, when officials first began press briefings on the virus, there was a disconnect between the perceived severity of the outbreak. On Jan. 31, CDC director Robert Redfield told reporters that the "risk to American public currently is low." The CDC's National Center for Immunization and Respiratory Diseases Director Nancy Messonier had said during a press briefing days earlier, on Feb. 25, that "disruptions to everyday life may be severe" from closures.

"By engaging the public every day, the public would be able to understand what is CDC learning, what is the public health community, globally, learning. And you can go along that journey so that it's not left standing out there that there's no worry here, because information very quickly started to come in that this would be a threat," Besser said. "And as soon as CDC states that, CDC was sidelined. It was no longer allowed to do the briefings."

"So, a point in time taken out of context… can look very strange," he added, "but if there'd been an ongoing dialogue and conversation with our public health leaders, it would [have been] part of that journey."

The former directors also said the U.S. needs to take a more proactive stance in preventing the next pandemic. Gerberding recently co-chaired a report titled "Ending the Cycle of Crisis and Complacency in U.S. Global Health Security."

"If you look at the tenure of the CDC directors that are participating in this conversation, each one of us has presided over some kind of important public health outbreak, whether it was AIDS or anthrax or SARS or Avian influenza or Ebola. We've all gone through the cycle of the crisis," she said. "The reactive investment, the incredible focus and attention for a short period of time, and then the absence of the sustained budget and support for really strengthening our public health system at the state local level, engaging with our health systems and getting the countermeasures and the equipment we need into our national stockpile to truly be prepared."

"We have to be proactive," said Frieden. "We have to build in peacetime so that we're more prepared when we're fighting a war against a virus or other microbe."

Frieden said that even when a vaccine is approved, "COVID will still be there." He said a vaccine is only one part of the response.

"It's not a magic thing," he said. "We still have 100,000 deaths a year from measles, and the vaccine against measles is one of the best we have. So a vaccine is, by all means, the single most important thing we could have to fight COVID."

Both Frieden and Satcher also pointed out the complexities of presenting a vaccine to the public, namely that "there's so many people who don't trust vaccines."

Frieden and Besser said they're worried Americans are becoming complacent with the inadequate response to the pandemic.

"I'm worried about getting too used to the horrible result we're getting," Frieden said. "We are a global laggard and we need to change our approach. We need to up our game and get ahead of the virus."

Nevertheless, each of the doctors expressed optimism that the U.S. will eventually overcome the pandemic.

"We will recover, but the question is: How long will it take?" Gerberding said. "While we're maintaining our physical distance, we need to come together as communities, as health leaders, as nations around the world to really say we've got to work collaboratively. That's a tall order in this very divided world, but it's about the pandemic. It's not about politics."

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smolaw11/iStockBy MEREDITH DELISO, ABC News

(NEW YORK) -- What are schools going to look like when they reopen this year?

It's a complicated question with few answers at this point: for some, there might be plastic guards on desks, hand sanitizer stations in every classroom, masks on students and staff and physically distanced seating.

Another one of those potential measures comes when students arrive at the door -- symptom checks. The health screenings, including temperature checks, have already become a common protocol in reopening businesses in the U.S., as well as for schools abroad.

But how do schools conduct those checks for hundreds, if not thousands of students in a safe and timely fashion?

As some of the country's K-12 classrooms gear up for reopening in-person, they're proposing a variety of health screening protocols, as well as re-envisioning their entrances to accommodate the demanding logistics of these new processes.

This is all while the value of the health screenings remains uncertain and gaps exist in the knowledge of how the disease is spread, specifically among children.

"The challenge of orienting students and parents and faculty to new routines and rituals, and just being clear about the who, what, where, when and how of how learning will happen, is tremendously hard," Eric Tucker, co-founder of Brooklyn Laboratory Charter Schools (LAB) in New York City, told ABC News. "We need to explain clearly and simply and with a level of simplicity so that there's clarity about what the expectations are."

A question of feasibility

While some authorities recommend the screenings for schools, they also note how difficult they will be to implement.

For instance, the American Academy of Pediatrics recommends that schools have policies for symptom screening, which is used to help identify symptomatic people, but says that temperature checks "must balance the practicality" of doing them for students and staff, including possible lost instructional time.

The Centers for Disease Control and Prevention (CDC) noted temperature screenings are "not helpful" in identifying students with COVID-19 who are asymptomatic or presymptomatic. COVID-19 symptoms also overlap with other illnesses, it said, making it hard to screen, particularly in young children.

The agency currently does not recommend that schools conduct screenings of all students in grades K-12, and for schools that are considering them to weigh their feasibility. It does recommend that businesses consider daily in-person or virtual health checks of employees.

New York City's schools chancellor has likened the symptom-checking process to a "TSA check-in at an airport" -- one that can take a lot of time and manpower, particularly for the city's larger schools.

"How do you efficiently do that?" Richard Carranza said during a virtual family and student information session last month, before adding that they are working with school administration to "flesh out" what that might look like. "We understand that that's important as well," he added. The city has yet to announce more details on temperature checks, and notes on its website that schools will create entry protocols, such as symptom checks, "consistent with the latest health guidance."

Implementation of temperature checks will vary widely across the country, as there’s no consensus among state school reopening plans on symptom screenings. An analysis of nearly two dozen state guidelines found that they range from requiring them for all staff and students to recommending that schools consider them or conduct "where feasible," to encouraging health assessments before arrival to ultimately referring districts to local health department requirements.

Some schools will find temperature checks a "burden," ABC News contributor John Brownstein, PhD, an infectious disease expert at Boston Children's Hospital and professor at Harvard Medical School, acknowledged. But since not everyone will be capable of "good self-assessment," we need "broad policies to do temperature checks to identify those that have been infected," he said. Since temperature checks won't be able to identify pre-symptomatic transmission, other measures, like having students in cohorts, become important in reopening schools, he said.

Screening at home instead

Given the logistics, some protocols may rely on students to be primarily screened at home for COVID-19 symptoms. The CDC recommends that "parents or caregivers should be strongly encouraged to monitor their children for signs of infectious illness every day." Students should stay home, it advises, until at least 24 hours after they no longer have a fever (temperature of 100.4 or higher) or signs of a fever, such as chills or flushed appearance, while unmedicated. The AAP also notes that temperature checks and symptom screening at home may be unreliable, but the "most practical and likely to identify the most ill children who should not be in school."

In New York state, current guidance from the governor's office requires schools to perform health checks and screenings, per state Department of Health guidance, including temperature checks. It notes that screening by caretakers before school is "preferred" to doing so at arrival. Illinois' school plan requires that schools conduct symptom screenings and temperature checks -- or that people self-assess before entering school buildings.

In its proposal for reopening, Philadelphia's school district requires that guardians, students and staff conduct a daily self-screen at home before going to school or work, including taking temperatures and monitoring a list of symptoms. The protocol won't be implemented for at least several months; after initially announcing a hybrid start to the fall, the district will be starting fully remote, with plans to revisit a hybrid model for mid-November.

School screenings so far

Some of the first school districts to reopen in-person this school year have implemented temperature checks, along with social distancing measures, as part of their arrival process.

At Alcoa, south of Knoxville, Tennessee, temperature checks with touchless thermometers are being deployed, and the number of students in school each day is limited.

At Corinth, in northeast Mississippi, the school district has seven thermal scanners across its elementary, middle and high schools.

"We thought because of the efficiency and accuracy of what we saw, that it was a worthwhile investment," Corinth Superintendent Lee Childress told ABC News.

At Corinth, students are screened 6 feet apart upon arrival, with separate entrances for those arriving by bus and by car, Childress said. A second, mid-morning scanning is also performed for students in pre-K through eighth grade to catch any latent fevers. The school is also keeping seating charts and other logs to help with contact tracing.

The school district established its protocols based on guidelines from the CDC, state health department and American Academy of Pediatrics, a school spokesperson said.

Corinth reopened on July 27, with families choosing either fully remote or in-person learning. About 82% of the district's 2,700 students chose in-person, Childress said.

Since reopening, Corinth has had to contend with several cases of the coronavirus. By Tuesday morning, the district had notified the public of five confirmed cases of COVID-19 in high school students. None were identified by the health screenings, a school district spokesperson said, but were reported by parents to the school nurses.

Those who have been in close contact with the students are quarantining for 14 days from their last point of contact, the school district said.

Rethinking arrival

In planning to reopen its doors later this month, Brooklyn LAB anticipated that performing symptom and temperature checks while also keeping its middle and high school students 6 feet apart would take time and space -- most of it spent outdoors in the elements. To that end, the school has reimagined its arrival process and environment.

"Our concern was that if the process was disorderly, if we just pretended that surrounding the front door there was enough space for a structured and orderly arrival, that it's kind of like walking into a grocery store that has no signage on the floor and no intentionality about how to maintain social distancing," Tucker said. "Most schools have not yet adjusted their physical infrastructure to account for what entry will actually entail."

The school is erecting a transparent scaffolding, dubbed the "front porch," that features signage on safety measures, flower planters and, when needed, heaters. The structure, which was made in collaboration with Urban Projects Collaborative, serves as an outdoor lobby. Students will be able to wait there while staff checks them in, conducting safety measures such as mask checks, hand sanitizer application, cellphone disinfection and temperature checks.

"It's important that there be places for social distancing and screening of students for symptoms to occur in a way that's pleasant and dry and warm and safe," Tucker said.

The school is currently training teachers on its new CDC- and NYC DOE-guided protocols and plans to start having students in the building on Aug. 19, when they can practice the new normal as well.

To decrease the on-campus population to get to 10-person classes, Brooklyn LAB plans to have staggered start times, with parents able to elect a four-hour in-person block in the morning or afternoon, and virtual learning the rest of the day. It anticipates having 800 students in person, and another 270 fully virtual.

To decrease the arrival waiting time, the school is exploring doing some of the checks before students leave home, as well as an app format, Tricia Forrest, project manager at Urban Projects Collaborative, told ABC News.

"Our ultimate goal is coming up with solutions that are grounded in science recommendations as much as feasible, given how people use spaces and buildings," she said, "and having solutions that will guarantee safety for our children as much as possible."

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Samara Heisz/iStockBy IVAN PEREIRA, JANET WEINSTEIN and JP KEENAN

(NEW YORK) -- July turned out to be another deadly month for the U.S. as hundreds of thousands of people contracted the novel coronavirus.

There were 1,882,692 new cases diagnosed throughout the month and 25,259 new COVID-19 deaths, according to data from Johns Hopkins University. In total, over 4.5 million Americans have contracted the virus and 152,000 have died since July 31.

The jump in infections took place in almost every state across the country, but the biggest rises were in Texas and Florida.

Florida's seven-day average for newly reported cases jumped from 7,140 on July 1 to 9,725 on July 31, according to the state's Health Department. On July 12, the state shattered the U.S. record of new cases with 15,000 reported that day. The state saw 3,300 COVID-19 deaths in July, according to the health data.

Texas' seven-day average for new cases went from 6,020 to 7,806 from July 1 to July 31, according to Texas' Health Department. The state recorded 3,569 new deaths in July.

Texas and Florida, which were one of the first to reopen to the public, surpassed New York in the number of cases by the end of the month and had over 418,000 cases, according to health data.

California, which had stricter COVID-19 precautions, also overtook New York's numbers with nearly 260,100 newly reported cases in July, according to the state's health data. The state recorded over 3,000 new deaths last month.

With the cases rising, and hospitals reaching the breaking point, state leaders made an about-face with their health policies.

California Gov. Gavin Newsom rolled back the state's reopening of indoor businesses, including restaurants, bars, gyms and movie theaters at the beginning of the month. After weeks of pleas from local leaders in Texas, Gov. Greg Abbott mandated face masks for the entire state, joining other states like Alabama.

While cities in Florida were allowed to institute mask policies and roll back their reopenings to turn the tide, Gov. Ron DeSantis did not issue a statewide order that called for those options. In Georgia, Gov. Brian Kemp attempted to sue Atlanta Mayor Keisha Lance Bottoms over her city's mask mandate, but it was dropped later in the month.

Dr. Shan Soe-Lin, the director at the nonprofit Ferro's Global Health Advisors, told ABC News there is enough evidence both locally and internationally to show that masks help control the spread of the virus.

"Montgomery, Alabama … was going through a really big surge earlier in June. They put mandatory mask policies and I've seen their curves started to flatten," she said.

Despite proven science, the White House has refused to issue a mandatory, nationwide mask policy. President Donald Trump did not wear a mask in public until July 11, when he visited Walter Reed Hospital.

Ten days later, he made his first coronavirus-related news conference since April and admitted the pandemic would get "worse before it gets better," a far cry from when he boasted the pandemic would be gone by the summer during briefings in the winter and spring. A week later he retweeted claims from a controversial doctor that contained hydroxychloroquine misinformation and asserted, without any evidence, that parts of the country were "corona-free."

Coronavirus's impact on the economy also took a turn for the worst.

At the end of the month, the U.S. recorded a 32.9% decline in GDP during the third quarter of the year, marking the worst loss in productivity in decades. A combined 5.6 million Americans filed for unemployment during the month, as several businesses shuttered throughout the country.

Unemployment benefits for those Americans expired on July 31 after Congress failed to reach an agreement over an extension on The CARES Act in time, but negotiations have continued into August.

One business sector that did see a comeback last month was sports.

Major League Baseball began its reduced season on July 24, with special guest Dr. Anthony Fauci, who threw the first pitch at the Washington Nationals' home opener against the Yankees. Less than a week later, several games were canceled after more than 15 Miami Marlins players tested positive for the coronavirus.

The NBA also restarted its season on July 30 with players living and competing in Orlando, Florida.

While the athletes began their adjusted schedules, a heated debate also took place across the country over the upcoming school year. Trump and several leaders have pushed to reopen classrooms despite major warnings from health officials and educators that it would put children, parents and teachers at a greater risk.

Soe-Lin said the only way to move forward and prevent more deaths is if there was a national policy that emphasized science-backed strategies like masks.

"We're just too busy fighting each other," she said. "And when you're too busy fighting each other … that's when COVID's just sweeping on by."

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Amornrat Phuchom/iStockBy KATIE KINDELAN, ABC News

(NEW YORK) -- Rachel Scott's son Braden was 5 years old when he was diagnosed in 2016 with acute flaccid myelitis, or AFM, a rare, rapid-onset neurological disease affecting the spinal cord leading to paralysis.

Josh and Gretchen Trimble's youngest daughter, Opal, was just 4 months old when she was diagnosed with AFM, one of the youngest patients ever to be diagnosed with the disease.

The Centers for Disease Control and Prevention began tracking cases of AFM in 2014 and a wave of them has occurred every other year since then.

Now, as the CDC warns about a potential AFM outbreak this fall, parents are speaking out about what they want others to know about the potentially lethal disease.

1. AFM can strike quickly and at any time.

When Gretchen Trimble dropped Opal off at day care one day in February of last year, she said she remembers thinking that morning how Opal was happy and pleasant.

A few hours later, Trimble was called to pick Opal up from day care because of her poor health. A few days after that, Opal was in the pediatric intensive care unit and diagnosed with AFM.

"The onset of it was just so sudden," said Trimble. "When I got the call from the day care and I went to pick her up, I was just blown away that she not only was acting so sick, but it was such a drastic difference from that morning. She was showing no signs of any kind of symptoms."

Scott's son, Braden, had a cold that Scott said at first was nothing unusual.

"All of my kids just had a mild cold, runny noses and nothing major," said Scott. "For everybody, the cold passed and then about a week later Braden started having these signs of paralysis and weakness."

2. It's crucial to know the warning signs of AFM.


Experts say seeking medical attention right away could make all the difference.

Symptoms of AFM include sudden arm or leg weakness, difficulty walking, limb pain, back pain or neck pain. AFM can cause paralysis over the course of hours or days, which may require a ventilator for breathing. It most commonly affects young children.

Most children with AFM will have a fever or respiratory illness about six days before weakness occurs. But why some children get AFM and some don't isn't yet clear.

Braden's first symptoms of AFM were difficulty swallowing. Scott, who had never heard of AFM, said she and her husband thought their son had a sore throat and attributed his weakness to the fact that he was not eating.

"Had [AFM] been something that we'd heard of before or seen in the news, it would have set off a red flag for us and our doctors," said Scott. "None of our doctors were considering [an AFM diagnosis] until he had stopped breathing and was intubated."

Scott stressed that parents need to pay close attention to their child's symptoms, even as an AFM outbreak could overlap with the coronavirus pandemic.

"The most important thing, especially right now when people are fearful of going into medical facilities and are trying to avoid places where sick people are congregated, if your child is experiencing any limb weakness, any facial drooping, any trouble swallowing, a cold or fever, that is a medical emergency and you need to go to the emergency room immediately," she said. "You cannot avoid seeking treatment out of fear of COVID-19."

3. AFM can be misdiagnosed.

Because AFM is so rare, it is still a disease that doctors are learning more about.

Scott's and Trimble's children were each diagnosed and treated for other illnesses before being diagnosed with AFM.

They were also each finally diagnosed with AFM after doctors ordered an MRI, which is what the CDC recommends health care providers order to distinguish AFM from other neurological conditions.

"I go back often playing the could have, should have, would have game," Trimble said of the several days it took for a doctor to order an MRI for Opal.

"What was crazy to us, because it's a one-in-a-million disease, that it was a learning experience for our doctors too," she said. "I would encourage parents to ask questions and know that doctors aren't going to have all the answers."

4. There is hope for children diagnosed with AFM.


Opal spent seven weeks in the PICU, where her parents were told she had a 30% chance of recovery. She then spent another several months at the Children's Center Rehabilitation Hospital in Bethany, Oklahoma, where she got treatment the Trimbles credit with her recovery.

She was paralyzed from the neck down at diagnosis and now, nearly two years later, has full movement in her upper body and is regaining movement in her lower body, according to Trimble.

"Don't give up hope, that's my encouragement to parents," she said. "Just expect big things from your child and position them and give them the resources that can foster that and know that there is always hope and there are always things to be thankful for."

Likewise, Scott's son Braden continues to make improvements every day, four years after his diagnosis. He is able to walk short distances, has full use of one arm and had his tracheotomy tube removed last year, though he still relies on a feeding tube for much of his nutrition.

"It's been a heartbreaking and devastating thing for my family, but it's not the end of the world," said Scott. "Braden is happy. He has a great life. It's not a death sentence."

5. There are resources available for help.

Both Trimble and Scott cited the need for support while confronting a disease that is so rare.

"Even though the numbers are small, for the families that it does impact, it's life-changing," said Trimble, who shares her family's journey on Facebook.

Scott, who also shares Braden's journey on Facebook added, "It's a very real thing that we're living with and it's something that parents need to be aware of before it's something that their kid is dying from."

The CDC has a resource page for people to find out more about AFM.

The Acute Flaccid Myelitis Association is a nonprofit organization that offers more information about AFM, as well as resources and support for parents.

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iStock/ipopbaBY: DR. ALEXIS E. CARRINGTON, EDEN DAVID, and SONY SALZMAN, ABC News

(NEW YORK) -- Amidst the COVID-19 pandemic, doctors are concerned that the prolonged shutdowns and stay-at-home orders critical in combating the novel coronavirus may have had dire consequences on early cancer diagnosis and treatment.

Now, a new study finds that new diagnoses for six common cancers, including breast and colon cancer, significantly decreased during the peak of the pandemic.

When comparing the number of weekly cancers diagnosed before and during the pandemic, "there was a 46% decrease in diagnosis of the six common cancer types we looked at, which included breast, colorectal, lung, pancreatic, gastric and esophageal cancers,” said Dr. Harvey Kaufman, the study's co-author and director of the health trends research program at Quest Diagnostics.

Researchers observed the weekly counts of first-time tests for patients associated with six cancers at Quest Diagnostics from Jan. 1, 2018, to April 18, 2020. The drop in diagnoses from March to mid-April is consistent with previous reports and are likely a result of the preventative measures taken at the outset of the pandemic to mitigate the spread of COVID-19, including delaying elective procedures and allocating health care resources for treating COVID-19 patients.

In fact, at the beginning of the pandemic, The American Society of Clinical Oncology recommended decreasing clinic visits and postponing cancer screening to "reduce patient contact with health care facilities."

Experts say that the potential consequences of these delayed diagnoses could have negative consequences for patients.

"The decline clearly represents a delay in making the diagnoses and delays matter with cancer," said Dr. Craig Bunnell, chief medical officer of the Dana-Farber Cancer Institute.

According to Kaufman, delays in cancer screening and diagnosis could lead to patients getting treatment at more advanced stages of their disease, which ultimately increases the risk of complications.

"When cancer screenings and resulting cancer diagnoses are postponed, some of these cancers are likely to later be identified at more advanced stages, which will result in poorer outcomes and even increased death rates," he said.

Experts say monitor for symptoms and signs of cancers

While we still continue to combat COVID-19 and adhere to the public health guidance of staying at home as much as possible and practicing social distancing outside, experts say that continuing to monitor for symptoms and signs of different types of cancers should not be overlooked, whether you’re at home or planning to go to the doctor.

"Recommendations for cancer screening depend on a variety of factors, including someone's age, gender, and family and personal history," said Bunnell. "People should consult their doctors, as they normally would, regarding the most appropriate screening tests for them, but they should not defer those tests unless they have first discussed that with their doctors."

He added, “We need to safely perform these diagnostic tests and the public needs to not think of them as optional. Their lives could depend on them."

With hospitals open, it's imperative patients come in for appointments, doctors say.

“Now that hospitals and clinics are reopening, it is important for patients to continue receiving their health screenings and examinations,” said Dr. Marjon Vatanchi, a board-certified dermatologist with the department of dermatology at Brown University.

The only people who may have to push back appointments, she explained, are those who have strict orders from their doctors to stay at home, like high risk populations or people with compromised immune systems.

Be your own health advocate

Doctors also say that you can serve as your own health advocate when it comes to catching cancer early. Even at home you can be on the lookout for any changes in your body that may be early signs of cancer.

Breast cancer: The American College of Obstetrics and Gynecologists and U.S. Preventive Services Task Force recommends that women routinely check their own breasts and notify their doctors about any changes in shape, masses, changes in discharge from the nipples, or redness, which may be signs of breast cancer.

Skin cancer: When it comes to skin cancer, Vatanchi recommends that everyone do their own monthly skin checks. "Americans can do entire body mole checks at home with a family member checking their back. If there is anything suspicious, then immediately call your dermatologist for a skin check and possible biopsy," she said.

Vatanchi also said to be on the lookout for any suspicious skin changes like "moles that are asymmetrical, have abnormal borders, colors beyond a brown monotone, diameter greater than the end of a pencil eraser, and moles that have changed recently."

Make healthy choices: According to the Centers for Disease Control and Prevention, you can also reduce your risk of cancer by making healthy choices like maintaining a healthy diet and weight, avoiding tobacco, limiting the amount of alcohol you drink and protecting your skin. Use the prolonged time at home now to take on healthier habits that you and your whole family will benefit from.

Keep scheduled appointments: These steps, however, do not substitute a visit to the doctor. It is important to keep up with the recommended cancer screenings and routine checkups with your doctor. Due to COVID-19, many doctors now even offer virtual appointments and staying on track with your appointments can be critical in cancer treatment.

"COVID-19 is a serious threat but cancer isn't going anywhere and needs to be caught and treated early," said Dr. Jeffrey Drebin, chair of the department of surgery at Memorial Sloan Kettering Cancer Center.

Alexis E. Carrington, M.D., is a dermatology research fellow at the University of California, Davis in Sacramento, California, and a contributor to the ABC News Medical Unit. Eden David, who studied neuroscience at Columbia University and is matriculating to Icahn School of Medicine at Mount Sinai later this year, is a member of the ABC News Medical Unit.

Contributing physicians Dr. L. Nedda Dastmalchi and Dr. Molly Stout.


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Lauren CortezBY: NICOLE PELLETIERE, ABC News

(LITTLE ROCK, Arkansas) -- A doctor who delivered a baby girl 25 years ago has now delivered her newborn son.

Dr. Bryan Cox of Methodist Hospital in San Antonio, Texas, delivered Lauren Cortez on March 23, 1995. Cortez's mom, Isabel Luna, has been his patient for over two decades.

"Lauren came to me as a pregnant lady and she was all excited because her mom loves me, so it was a great situation," Cox, a 33-year practicing OB/GYN told "Good Morning America." "It was fun the whole pregnancy."

Cortez told "GMA" she wanted Cox to be her doctor after her mother spoke so highly of him. All came full-circle when Cox delivered Cortez's son, Logan James, who was born July 26, weighing 6 pounds, 1 ounce.

"Dr. Cox, right when the baby is born, he sings 'Happy Birthday,'" Cortez told "GMA." "The fact that he takes that little time to personalize the birth experience meant a lot to me."

"My mom said he sang 'Happy Birthday' to me, and to my brother who was born in '97," she added.

Cortez posted her story onto Twitter where it was shared over 82,000 times.

25 years later, the doctor who delivered me also delivered our son!! 👶🏻😭 pic.twitter.com/RMgskxGiU2

— Lauren Cortez (@_vivalaluna) July 28, 2020


Many of Cox's patients commented on the thread, and others had something in common with Cortez -- their OB/GYNs delivered them, and their children too.

Cortez said she and her husband Peter hope Dr. Cox stays in practice until Logan has children of his own.

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ghornephoto/iStockBy the GMA TEAM, ABC News

(NEW YORK) -- One expert says the risk of spread on school busies is low if the right precautions are taken, and that ventilation is key.

School is back in session in some parts of the country, raising major questions about how to transport kids safely to class amid the pandemic.

With 26 million bus-riding students, districts are taking extra precautions to help stop the spread of COVID-19.

A video released by Casey County Schools in Kentucky, shows what a new morning commute might look like for its students.

All students must wear a mask and parents are asked to take their child's temperature before they board the back of the bus. Children are asked to use hand sanitizer as they head to their seats. Once they leave, a team fully disinfects the bus.

Dr. Mary Beth Sexton with Emory University School of Medicine said the risk of spread on buses is low if the right precautions are taken, and ventilation is key.

"The main problem with a bus is that you don't have a lot of circulation," Sexton told "Good Morning America." "There's nothing that happens naturally unless you're in a position where you can open the windows."

The Center for Disease Control and Prevention recommends students wear face coverings and sit one child per row while skipping rows whenever possible.

To achieve that, the National Association for Pupil Transportation said there should be fewer kids on board.

"One of the largest things that's being done is the changing of bell times that will enable school buses to run multiple routes during the day to get students to and from school safely," said Steven Simmons, president of the NAPT.

Some superintendents are encouraging families to avoid the bus altogether if they can, though that may not be an option for working parents.

 

As more students go back to school amid the COVID-19 crisis, school buses are adapting to keep kids safe during the pandemic. @WhitJohnson has more. https://t.co/v3xKiEi4a7 pic.twitter.com/XWOOkLcgKH

— Good Morning America (@GMA) August 6, 2020

 

"If they have the ability to transport their children to school, we'd ask them to do so," said Chris Piper, superintendent of Troy City Schools in Ohio.

Another proposal is "walking school buses," which is a pre-pandemic program which could be a big help in Kentucky.

The Department of Education said this model could allow groups of kids who live nearby get to school safely by way of an adult chaperone who would pick up children along the way.

Dr. Jennifer Ashton, chief medical correspondent for ABC News, said when it comes to school transportation, it's about lowering the risk as much as possible.

"It's really about ventilation and distance, so there are viral factors, there are human factors," Ashton said.

"It's not a one-size-fits-all approach," she added. "It will have to depend on what's going on in that area, what's going on in that region, what kind of transmission we're seeing and the individual health and risk factors of those students and the people at those students' homes."

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maroke/iStockBy GENEVIEVE SHAW BROWN, ABC News

(NEW YORK) -- With all the uncertainty surrounding going back to school, shopping for supplies seems like a quaint idea from another time.

But school, in one form or another, will resume in the coming weeks, and supplies, whether for remote learning or in-person, will still be required.

"As a parent, I think, 'should I be buying PJs and sweats or back-to-school clothes?' Who knows?" said sixth-grade teacher and mom of four, Kassia Messina.

ABC News' Good Morning America asked several teachers what's on their back-to-school wish lists -- what otherwise unusual items may prove essential for teaching during these trying times?

From special masks to hand sanitizer -- and lots of it -- consider stocking up on these items to get on the good side of your favorite teachers:

Clear face masks

For Laurel Wyatt, a preschool teacher of 4-year-olds in New York City, clear face masks for both teachers and kids are an item she thinks will be useful this coming year.

"It's important for the kids to see my mouth while I teach them letter sounds and to see my expressions throughout the day," she said. "Kids pick up so much from facial cues in addition to spoken word."

And she hopes the kids can have them too.

"Kids rely on social cues from one another," she said. "Peer modeling is also crucial for building language and problem-solving skills."

Wireless microphones

For schools that require teachers to wear face coverings, wireless microphones are wanted to help keep their voices from being muffled. The Chicago Tribune reported that 300 had been ordered for one school district this fall.

Susan Gianiodis, a teacher in Buffalo, New York, wrote that she has one on order: "I'm nervous that my voice, never very strong, will be hard to hear through the mask."

Headphones

For kids on an alternate in-person schedule or who are exclusively learning remotely, several school districts are asking every child to have their own headphones.

At Centennial Elementary in Circle Pines, Minnesota, headphones are required for all students up through fifth grade. At Huddleston Elementary School in Peachtree City, Georgia, headphones or earbuds are required depending on the age of the child.

Headphones are important, "especially for kids with lots of background noise at home or for sheer focus, headphones can really help with communication on both sides [for both] student and teacher," said New York City preschool teacher and mom of a middle schooler Brassfield Honores.

Clorox wipes

This "must-have" back-to-school item was mentioned by nearly every teacher we talked to, but it's going to be almost impossible to find: Clorox wipes. ABC News reported Clorox said fresh supplies may not be available until later in 2021.

In an earnings call earlier this week, Clorox company president and CEO-elect Linda Rendle announced the company might not be able to restock the product in stores until next year.

Hand sanitizer

Every teacher GMA spoke to mentioned hand sanitizer as a must-have item, and even if your school is stocked up, they said there's no harm in having your child take their own.

Messina in her 14th year of teaching in Marlboro, New York, told GMA that "If your child is responsible enough to have it with them, it can't hurt."

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smolaw11/iStockBy ELLA TORRES, ABC News

(WAKE FOREST, N.C.) -- Fourth graders at a school in North Carolina have been asked to quarantine for 14 days after a student there tested positive for COVID-19.

The school, a Thales Academy in Wake Forest, said it was notified on Monday that the student became infected after having contact with an infected family member.

The student was asymptomatic and was last at school on Friday. Teachers who were exposed also will be quarantined.

Thales Academy, a network of private non-sectarian community schools with eight locations in North Carolina, made the news last week after Vice President Mike Pence and Secretary of Education Betsy DeVos visited a classroom and applauded the school for reopening.

Pence and DeVos visited a campus in Apex, not Wake Forest.

"We're here today because to open up America, we've got to open up America's schools and Thales Academy is literally in the forefront," Pence said.

Pence also said that the administration was going to make sure schools had the resources to open safely.

"We really do believe that it's in the best interest of our children to be back in the classroom," the vice president added.

Thank you to Mrs. Combs’ 4th Grade Class! We are so proud and happy to see you all back in school! @Thales_Academy has taken careful steps to keep everyone healthy and we are grateful for the countless hours put in to open the academy and get kids back in the classroom! pic.twitter.com/KgtuHLDPt2

— Mike Pence (@Mike_Pence) July 29, 2020

Thales welcomed students back July 20. It offered parents two options: fully online or fully in-person, according to ABC Durham affiliate WTVD-TV.

Students had their temperatures taken and completed a medical questionnaire after they were dropped off, according to WTVD. Staff and faculty also reminded students to wear masks.

Because the school network is private, it doesn't have to adhere to North Carolina Gov. Roy Cooper's school reopening guidelines.

Cooper announced in July that schools could reopen with both in-person and remote learning.

He said that schools that choose to reopen should operate in person at no more than 50% capacity and buses at no more than 33%.

The U.S. Centers for Disease Control and Prevention has swayed on national guidance for reopening schools. Originally, the federal agency warned of the risks that come with reopening schools and issued recommendations. But on Thursday, two weeks after President Donald Trump demanded schools reopen, the CDC shifted its tone and released statements about children not being at a high risk of getting seriously ill, though its original guidance still remained on its website.

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Dr. Jacqueline Delmont is the chief medical officer of SOMOS, which has expanded from New York City to other cities affected by the coronavirus to provide testing. - (ABC News) By KRISTOFER RIOS, CLAIRE PEDERSEN, DEBORAH KIM and ANTHONY RIVAS, ABC News

(NEW YORK) -- One doctor in Miami started her own COVID-19 testing site while another in New York City partnered with a group of testing sites in order to better treat these underserved populations.

In a predominantly Latino neighborhood in the Bronx, New York, doctors working through the non-profit group SOMOS Community Care have spent months on the frontlines of the coronavirus pandemic.

Now, those same doctors are traveling to other cities around the country that have been seeing surges in new COVID-19 cases in an effort to get free testing to communities of color, which have already been hit disproportionately hard by the virus and face scarcities in access to testing as well.

One of these doctors is Dr. Jacqueline Delmont, chief medical officer of SOMOS, who has been working for free operating a pop-up free testing site in Miami Lakes, Florida for the past two weeks.. The doctor, who is originally from Venezuela and has devoted her career to helping fellow immigrants, said “the moment” they arrived, people were lining up as early as 4 a.m. to get tested.

The pandemic has pushed Delmont to use all the skills she’s learned during her career.

“It’s an unprecedented time. … I’ve been able to use my administrative skills, but my clinical skills, the empathy coming from a family with limited resources, understanding that there are definitely differences in the communities in terms of access to information, to medication, to mobile devices, to appropriate internet,” she said.

Dr. Yomaris Peña, a volunteer with SOMOS, said working at one of the organization’s testing sites is “another mission where I’m helping my Hispanic, my Latinos, my African American family … everyone that is underserved.”

Medical experts have said testing is a key tool in stopping the viral transmission of COVID-19. Yet, an ABC News and FiveThirtyEight review review of U.S. Census data and testing site info throughout the 50 states and the District of Columbia found that in many cities, testing sites in and near predominantly Black and Latino neighborhoods were likely to serve more patients than those in predominantly white neighborhoods. The review also found disparities between richer and poorer neighborhoods, with testing sites scarcer in poorer ones.

It noted “particularly” large disparities in testing access in and around many cities, so called urbanized areas, like San Antonio, Baltimore, Los Angeles and Miami.

“It’s devastating that the communities that need it the most, the communities that have been most affected, the communities that we could have made a greater impact in controlling the pandemic, have not had the access to testing,” Delmont said.

She said it’s “very disheartening” being unable to test many within these communities early because it doesn’t allow them to be proactive in isolating those who become ill. With many people in these communities living with their families -- including elders -- this puts them at risk.

Natalie Choy, 16, recently received a second COVID-19 test two weeks after her first one came back positive. She says her whole family has been sick with the virus, and hopes the second test will give her the all clear.

“My mom, my dad, my little brother and then my two little baby siblings and my grandpa all live with me, and pretty much everyone experienced symptoms, including the babies,” Choy said.

She said it was easier to social distance inside the house when it was just her father who was sick -- he was the first to test positive. Once other people in the family contracted the virus, it became more difficult. “I share a room with my brother, so it wasn’t realistic at all. We really couldn’t do anything at all except wear a mask. We still do.”

With such a large family, the SOMOS testing site has also helped people, who otherwise may not be able to afford testing, have access to the service.

“People who can have the money and the things just to be able to pay for every single test, they have much easier access. … That’s fine, but when it’s five, six or seven people, some people simply can’t afford it.”

Delmont pointed out that some families have other obstacles to receiving these services.

“Many patients have lost their insurance. They fear that they’re going to get a bill. Many of them are undocumented,” she said. “We understand that the federal government is not necessarily covering these tests for undocumented [immigrants].”

Carmen Guerra, an associate professor of medicine at the Perelman School of Medicine at the University of Pennsylvania, specializes in health disparities. She says that for people who don’t have insurance, “the only other options are to rely on publicly funded means of testing, whether that’s through public health sites in your city or town, or through philanthropic funds.”

SOMOS is one of the organizations around the country that has been there to fill in these gaps. In Houston, Sonia Gomez’s husband had been reluctant to get a test despite their family showing symptoms of the virus.

When they arrived at SOMOS’ Houston site, she said her husband was “very happy that they weren’t asking for any information about … status or papers.”

Gomez said she drove 30 minutes to get to the testing site and that they were taken in quickly by SOMOS doctors -- she said she had tried other places and the wait was about three to four weeks “because the testing sites are very full right now.”

A few days after receiving a test, Gomez tested positive for the virus.

“It was very shocking and scary to know that all of us are tested positive and it’s so dangerous. People are dying. It’s just crazy,” she told ABC News.

SOMOS was co-founded in 2015 by Dr. Ramon Tallaj after he immigrated to the U.S. from the Dominican Republic in the 1990s, and now has over 2,500 doctors who can speak five languages with their patients.

“Our patients are immigrants like us,” he said. “We speak the same language. We know exactly what’s their problem about housing, money, jobs. Then we had to work with them in any way possible.”

When the pandemic first swept through New York City, the Bronx was the epicenter of the epicenter, and SOMOS was there to help -- the organization partnered with New York State to expand to 28 additional sites. As the organization has expanded its efforts to other cities, Tallaj says SOMOS doctors have conducted close to a quarter million tests.

“From the beginning, we’ve been crying to get testing in our community,” Tallaj said. “But we did it ourselves. We put on the line a lot of money … and we want to continue for our own people.”

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Courtesy Malone MukwendeBy LARA PRILUCK, ABC News

(NEW YORK) -- Upon arriving at medical school at St. George's, University of London, 20-year-old Malone Mukwende was often taught to look for symptoms that only pertain to white skin.

For instance, Kawasaki disease, which is inflammation of the body's arteries and is mostly found in children, is often associated with a red rash. But as Mukwende, who is originally from Zimbabwe, sat in class, he was disturbed by the fact that a simple red rash was not how the symptom would appear on his own dark skin.

In fact, beyond Kawasaki disease, there were a whole host of images in Mukwende's textbooks and slides in his classes that didn't accurately describe the way symptoms would appear on dark skin.

"When flagging to tutors, it was clear that they didn't know of any other way to describe these conditions," Mukwende said. "And I knew that I had to make a change to that."

Mukwende continued asking questions, but he was often sent to go and look for the answers himself.

"It was clear there was a major gap in the current medical education," he said.

Enter Mind the Gap: A Handbook of Clinical Signs in Black and Brown Skin, a book Mukwende is set to publish along with two lecturers at St. George's: Dr. Peter Tamony, a senior lecturer in clinical skills who also works to improve inclusivity and diversity in medical education, and Margot Turner, a lecturer on diversity in medical education.

The three received a student-staff partnership grant and the project took off. The resource will feature images to help medical workers identify conditions on darker skin, as well as suggested language for them to adopt while describing the symptoms.

"I am excited to see the change in the curriculum and learn medicine to be able to treat a wide range of patients," Mukwende said of his efforts, which have come with their own set of challenges. "Many people rejected the work initially, stating that it is common sense or it is stuff that everybody knows."

"I knew that I had to make a change as I wasn't happy with the way things were currently being taught," he said.

Doctors, and especially doctors of color, have been flagging gaps in medical education for years. It appears now, underscored by the work of Mukwende, that their concerns are gaining a wider audience.

This comes as the world continues to reel from the impact of the coronavirus pandemic, which has shined a spotlight on the ways systemic racism has disproportionately affected health and social inequality of racial and ethnic minority groups. In the United States, Black people are dying at 2.5 times the rate of white people. They're more likely to be working front-line jobs, experience poverty, and, as a result, have the pre-existing medical conditions that lead to more dire outcomes should they contract covid-19. It also comes amid the social and political unrest surrounding the death of George Floyd in police custody.

Dr. Adewole Adamson

Dr. Adewole Adamson, a dermatologist and assistant professor at the University of Texas at Austin Dell Medical School, is passionate about health policy and teaching about health care inequality.

"There have been decades of, particularly, dermatologists of color that have been screaming about this issue and not getting much traction," Adamson said.

Taylor and Kelly's Dermatology for Skin of Color, which Adamson identifies as the premier work on the subject, was first published more than 10 years ago. There have been other established resources for dermatologists and clinicians, as well as organizations such as the Skin of Color Society, that strived to better explain how conditions manifest on dark skin for years as well. Adamson is happy Mukwende is adding to this work.

He still sees a lack of representation in literature he encounters as a specialist, a practicing dermatologist whose focus and expertise is on the skin itself, so he's not surprised Mukwende, too, experienced a lack of representation sitting in his medical school classes.

Ultimately, though, separate handbooks and manuals educating people on what conditions look like on darker skin is not the goal, Adamson said.

"We should be striving for inclusion in the 'main text,'" he said. "Even in the field of dermatology, some of our main textbooks, they have fallen short on that, which tells you just how intractable the problem is."

Dr. Vanessa Grubbs

Dr. Vanessa Grubbs, a nephrologist and associate professor at the University of California, San Francisco, says the issue of racism in kidney care manifests often in the grouping of Black and dark-skinned patients together as a biological group, leading to medical assumptions that don't take into account the care an individual needs.

"It's been 20 years and they've not bothered to try and figure out what Black race really stands for, because in this country there's an assumption that Black people are somehow genetically different than everyone else," she said.

Here, she says, race is used as a genetic marker when it's not one.

"We should be focusing on the differences between people that actually make a difference, like skin color and how rashes look differently on different skin color," Grubbs said.

She recalls a time during her medical training that she was called into the emergency room to see a young patient with dark skin who doctors thought had deep vein thrombosis, or clots in the large blood vessels. She remembers he had raised quarter-sized bumps on his shins and, to her eye, they had a little redness. When she looked at his chest x-ray, she realized he didn't have clots in his leg. He had sarcoid, or an inflammatory disease often affecting the lungs.

She reflects on how early in her career, as a doctor of color, she caught this issue as the doctors around her could not -- largely because they weren't trained to notice the symptoms.

"To me it was like, that's exactly what it is," she said. "But I think the doctors in the ER could not recognize that he had what are classic bumps on your shins, because they couldn't really tell that -- on his dark skin -- that they were red."

She added, "I think about if I didn't have that ability for myself, then his diagnosis would have been completely missed."

LaShyra "Lash" Nolen

LaShyra "Lash" Nolen was named the first Black female class president at Harvard Medical School last September, and she's been using her platform to raise awareness on issues of racial equity and social justice within the institution ever since. An article she wrote on the lack of training medical students receive on detecting Lyme, a flu-like disease carried by deer ticks, on dark skin, was published by the New England Journal of Medicine last month.

On white skin, Lyme typically manifests early in the infection with a bull's-eye shaped red rash. After a student in Nolen's class asked what that rash would look like on darker skin, the professor said it would be more difficult to see. The early stages of Lyme disease cause fever, headache and fatigue, and can be treated with a few weeks of antibiotics. But, if left unnoticed and untreated, the disease can spread to the joints, the heart and the nervous system.

As a public health-focused major in undergrad, Nolen said she studied the toll institutional racism has on the physical body.

"I learned that a lot of the conditions that I saw my family members experience, growing up in these dilapidated communities because of systemic racism, and lack of access to health care and insurance, etc., were the reason that they now suffer from so many preventable diseases," she said. Diseases, she enumerated, such as depression and diabetes.

But she hopes for change, and part of that change takes root in the classroom.

"My goal is that for every person that's graduating from medical school or health professional school to have the tools that they need to serve communities that look like mine," she said. But she recognizes that her work, and the work of Mukwende in London, comes after the work of generations of doctors and health care professionals fighting for awareness.

"I think that Malone and I, we now have the platform. We now have this energy where society is like, 'Oh yeah, we need to do the work of anti-racism,'" she said. This moment in history is amplifying their voices, bringing them to a wider audience than ever before.

"We're in the middle of this awakening, so it's the perfect time to really start to push the envelope," she said. "But I do think it's important for us to recognize that there are scholars who have dedicated their entire careers to doing this work and I think that it's important we uplift that."

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Rawf8/iStockBy NICOLE CURTIS and ANGELINE JANE BERNABE, ABC News

(PITTSBURGH) -- With the coronavirus pandemic keeping Americans at home, many have learned how easy it is to develop unhealthy habits like over-snacking or not exercising.

But Joe Mull, a 43-year-old father of three from Pittsburgh, has used his time during quarantine to develop a healthier lifestyle.

"The thing about quarantine is a lot of the distractions were no longer there for me," he told Good Morning America. "The weight just started falling off."

Before the pandemic, Mull said he always had a toxic relationship with food and was on track to have a heart attack by age 50.

"I was miserable. I spent a lot of time being awful. I had no energy," he said. "I started to believe that I didn't have a lot more 'next times' left."

Instead of dwelling on the things that he felt negative about, he changed his mindset and turned to the keto diet to help him shed some weight.

On the keto diet -- with its focus on a low carbohydrate and high fat way of eating -- Mull went from eating a cheeseburger and French fries for lunch to having a salad with avocado and turkey and cheese on a low-carb wrap instead.

"I started on March 9th with a commitment to keto and just took it one day at a time," he said. "I said I’m going to show up today and eat this way. I’m going to be active, and at the end of every day I got to experience that feeling of accomplishment."

"And then when you start stacking days together like that, you get momentum," said Mull.

In a matter of months, he dropped 45 pounds.

"I have to focus on making a small, daily commitment, which is ironic because I make a living speaking about commitment in the workplace," said Mull. "I had to apply the same lessons to myself that I teach managers across the country, which was to focus on making small changes to your routines and your habits that will produce the results that you want."

The hardest part about following the keto diet for Mull has been resisting the foods he has in the house for the rest of his family and instead choosing what he describes as "real foods, whole foods that are low in carbs and low in sugar."

"I’ve got three kids at home under the age of 10 and so we have snacks and treats in the house and so it’s learning how to recognize those urges, pause, walk away and choose something else," he said. "That’s something that will always be a struggle but that I have to just take one day at a time."

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