iStock(NEW YORK) -- In normal times, Mammoth Lakes relies on tourists -- skiers who fly into the 8,000-person California mountain town in the winter, and hikers and fishermen who flock there in the summer -- for its livelihood.
Mammoth Lakes' remote location, three hours from Reno, Nevada, and five hours from Los Angeles, is part of what makes the town a serene getaway. But with just one hospital, 17 beds and four ventilators, locals worry that they're sitting ducks if, or more likely when, COVID-19 spreads here in earnest.
Fifteen patients so far have tested positive at Mammoth Hospital, three-quarters of whom have needed ventilators. While the hospital was able to transfer patients who needed higher-level care to partner hospitals, Thomas Parker, Mammoth's CEO, worries about what will happen in a few weeks, when those partner hospitals inevitably fill up.
"They’re going to get saturated," Parker warned. "That ability for us is going to go away pretty quickly."
The United States' response to the ongoing COVID-19 outbreak has largely focused on hotspots like New York City, where case counts and deaths have overshadowed clusters elsewhere in the country. And President Donald Trump has continued to downplay the threat to areas that haven't seen a surge in cases, deferring to those states to impose stay-at-home orders.
But while it's taking longer for the virus to spread in country or mountain towns, experts say that rural communities, which often rely on metropolitan hospitals as a safety net, are tinderboxes poised to ignite.
"All the rural guys look like they're fine, but they're not," said Lynn Barr, the CEO of Caravan Health, a consulting group that advises rural hospitals and health clinics around the country. "If they don’t plan, it will devastate them," she added.
"It’s like watching a car accident in slow motion. You can see where it ends."
Hundreds of rural communities that used to have a hospital lost them in recent years. Ninety five rural hospitals closed between January 2010 and January 2019, according to the Department of Health and Human Services's Federal Office of Rural Health Policy. What is especially pertinent now is that 32 of those were critical access hospitals, meaning they offered 24-hour emergency care services 7 days a week.
Research by the North Carolina Rural Health Research Program shows that 170 rural hospitals have closed since 2005, and that 2019 was the worst year since then, with 19 rural hospital closures across the country and three in Tennessee alone. The numbers underscore the fact that during the pandemic, thousands of Americans could have to travel dozens of miles for emergency and inpatient care.
“The effect of these rural hospital closures will be more acutely felt than they have in the past,” said George Pink, the program's deputy director.
With aging populations, low government reimbursement rates, and high numbers of people still lacking insurance, rural hospitals have closed over the years because they simply could not afford to keep the lights on, Pink explained. Now they are facing tough choices about which surgeries merit attention during the COVID-19 crisis and even more rural hospitals could be in jeopardy of going bankrupt or running out of savings, just like other hospitals are around the country.
“Just as we need them most [in this pandemic], they are in a precarious financial positions," Pink said. "There are hundreds of rural hospitals that have less than two weeks' cash, and now they are cutting off elective surgeries to get ready for an influx of COVID-19 patients." Elective surgery is their financial lifeline, he added.
“Some hospitals just cannot make payroll. Unless all of your staff are willing to work for nothing, that is the reality some of these hospitals could face,” he added.
Hospitals around the country share Mammoth Hospital's worry about metropolitan hospitals filling up and being unable to admit rural residents who need intensive care or ventilators.
"Rural hospitals generally rely on transferring their patients,” Barr said.
The single hospital in Juneau, Alaska, provides health care to dozens of surrounding smaller communities, but also sometimes sends patients to bigger facilities in other cities.
“We medevac a lot of patients and that’s another concern, if we do get a surge of sick patients and Seattle or Anchorage are overwhelmed, too, will they be accepting patients?” Annie Nelson, an emergency department nurse at the Bartlett Regional Hospital in Juneau told ABC News.
In overflowing city hospitals, doctors on the frontline are already talking about battlefield-style triage. When there aren't enough ventilators to go around, doctors will have to rely on policy to decide who gets life-saving treatment. Frequently, such policies prioritize health care workers, first responders and younger and healthier people at the expense of the old and sick.
It's a devastating burden for any health care provider to be tasked with and for rural providers there's an added wrinkle: doctors will likely be forced to choose between patients they know personally.
"I have this deep, emotional feeling about what it’s going to be like when we’re sitting there with seven patients who need a vent, and we only have three vents, and we know every one of those patients," Barr said.
"It’s your kids’ school teacher," she said. "Triage was never intended for people you know.”
For Americans in rural communities, traveling long distances to doctors or hospitals were major barriers to care before COVID-19. Faced with a contagious virus ravaging that's ravaging communities, many families have not been able to stay with patients who were sickened by COVID-19, while they get care.
“If you are elderly or poor or disabled, or you live 25 or 30 miles away, having family visit or accompany you to a hospital could be a big barrier,” Pink said. “The sense of isolation is going to be much worse for older and sicker patients in rural areas.”
Rural patients may face logistical challenges getting care in the first place, explained Courtney Gidengil, a senior physician policy researcher at RAND and lead author of a 2018 report on the United States' response to the Ebola outbreak.
"It depends on how robust the infrastructure is in some of these places," Gidengil said. "You need EMS to be able to come to you and bring you to a hospital. You need the hospital to not get overwhelmed and then you need expertise within hospitals."
Testing in rural areas could be harder logistically, Pink noted. Other major factors include whether ambulances are driven by volunteers or staff and whether the nearest hospitals have fully functioning special services or whether they regularly rely on bigger hospitals. In the rural communities Barr works with, it's not unusual for EMS and fire departments to be made up of volunteers.
"How trained are these people?" she asked. "If there's a surge, how do you handle that surge with no EMS capacity?"
Rural communities may be farther from medical centers and it may be harder to get to them, Gidengil explained. In addition to supply shortages, many rural communities have shortages of specialists.
“So far, we’ve seen the middle of the country relatively spared compared to the more populated coasts, but I think that is likely to change," she said.
"There’s no reason to think that it’s not possible that COVID will hit them as well."
In addition to health care access obstacles, rural populations tend to be older and to have morbidities, like smoking, hypertension and obesity, which can be risk factors for severe and fatal cases of COVID-19, Gidengil noted.
"We’re still learning about the disease, but it seems like those types of comorbidities and age together really put people at risk."
In the 10,000-person town in rural Nevada where Barr lives, there are no delivery services -- no Uber Eats, no DoorDash, no Amazon -- which have been crucial in allowing social distancing in urban and suburban areas. Barr's lucky. Her town has a grocery store. Many of the rural communities she's visited across the country don't.
"We’ve been fundraising in our community to subsidize delivery of food to seniors, so that they can shelter in place," she said. "If we can’t get anything delivered to them, they can’t get food or drugs. They don’t even get mail.”
Instead, Barr said, everyone goes to the post office, which isn't ideal for social distancing. "Post offices are completely overwhelmed," she said.
A significant number of Americans may be faced with these issues in weeks to come.
"This is 60 million people who live in these areas," Barr said, referring to the one in five people who reside in rural America.
For Barr, these aren't hypothetical concerns.
While she hasn't been tested for COVID-19, she says she started having mild symptoms, including fatigue and a headache, which can be markers of the disease. Food has tasted strange to her for five days and she's been sleeping constantly. Barr knows that the critical access hospital in her town doesn't have any ventilators. It also doesn't have a single ICU bed.
"I told my husband, if this gets much worse, you have to drive me to the nearest city,” she said.
"I’m not old. I’m not young. But I might make the list of patients that they keep alive."
Parker has already seen his worst fears play out, in Idaho’s Wood River Valley, home to the popular Sun Valley ski resort.
Blaine County, where the ski resort is located, has reported at least 365 COVID-19 cases and two deaths in a population of 22,000, a per capita positive testing rate greater than New York City (roughly 1.6% versus 0.6% respectively).
The coronavirus “tore through this valley like a wildfire,” Brent Russell, an emergency room doctor at the local hospital, told The Washington Post. Russell's hospital partially shut down after multiple doctors, including Russell, tested positive, and they transferred patients to health care facilities hours away.
Worst of all, residents fear that the same tourists who power the ski resort town's economy brought the virus to the region.
"We must discourage friends and visitors from coming to town," Mayor Neil Bradshaw wrote in an open letter in the Idaho Mountain Express. "As well as the threat of introducing infected persons into our area, it will put additional strain on our medical resources. The message is clear: This is not a place for a virus vacation."
Parker is doing everything in his power not to have repeat that situation in Mammoth.
Last week, he wrote a letter to Gov. Gavin Newsom, asking him for six ventilators, and a checkpoint on the main roads into town, to screen tourists and second-home owners who may be headed for the mountains as outbreaks in cities like San Diego and Los Angeles peak.
"We are gravely concerned that if people who frequent this area for recreation decide to come here at this time, we will be overwhelmed," Parker wrote.
He worries that treating a rush of patients with respiratory symptoms will be even harder at an altitude of 8,000 feet. Weather is also on his mind. It's still winter in the Sierras. "We have four days of snow coming, starting this weekend. Weather can make it either difficult or impossible to ship a patient out," he said.
Parker has ordered more ventilators and PPE, but they're not scheduled to arrive for six to eight weeks, and even then, he's not confident that they'll arrive in time.
"An influx of patients from metropolitan areas is one issue that we can’t control," Parker said. "What we’re asking for is help."
"Rural hospitals are taking this very seriously," he added. "We know there is no true barrier for this virus."
Powerofflowers/iStock(NEW YORK) -- The Centers for Disease Control and Prevention is advising the use of cloth face coverings during the novel coronavirus pandemic, even do-it-yourself covers.
The CDC said cloth face masks are also important to use by those not exhibiting symptoms.
"The virus can spread between people interacting in close proximity -- for example, speaking, coughing, or sneezing -- even if those people are not exhibiting symptoms." according to a statement on the CDC’s website.
"In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission," the statement continued.
The CDC states that cloth face masks can be made from common household items, and while they are not medical-grade, it is important that medical-grade masks including surgical and N95 masks are reserved for health care workers currently facing a dire shortage of protective equipment.
In a video on the CDC’s website. U.S. Surgeon General Dr. Jerome Adams said that cloth face coverings can be made from an old scarf, bandanas and hand towels, and shows how to fashion a face covering from a t-shirt and two rubber bands.
On Friday during a press briefing, President Trump said that the CDC was now advising Americans to wear non-medical masks in public, adding it was voluntary and that he would not wear a mask.
As of Saturday morning, over 7,000 people in the United States have died from COVID-19. There are at least 278,458 diagnosed cases in the U.S. and more than 1.1 million around the world.
4X-image/iStock(NEW YORK) -- A doctor who is on the frontlines of the coronavirus pandemic in New York City has captured viral attention with a message she shared on Twitter to her two children.
Dr. Cornelia Griggs, a 36-year-old pediatric surgeon and mother of Eloise, 4, and Jonah, 1, tweeted a photo of herself in full personal protective equipment on March 29 writing, “My babies are too young to read this now. And they’d barely recognize me in my gear. But if they lose me to COVID I want them to know Mommy tried really hard to do her job. #GetMePPE #NYC”
"[That moment] reflected a really raw and emotional moment for me in the hospital,” Griggs told Good Morning America. "All of us who are showing up to do our job every day are facing the fear of getting sick or getting someone in our family sick and I wanted my kids to know that despite all of that fear and uncertainty and chaos, that I love my job. I would still choose to be a doctor 1,000 times over, because I feel privileged to do the work that I do."
My babies are too young to read this now. And they’d barely recognize me in my gear. But if they lose me to COVID I want them to know Mommy tried really hard to do her job. #GetMePPE#NYCpic.twitter.com/OMew5G7mjK
"My hope for my children, beyond their physical safety and health, is that they find something in the world that brings them that kind of meaning," she said.
Griggs has been treating patients inside a New York hospital since the spread of the novel coronavirus, COVID-19 -- the new respiratory illness in which more than a million have been diagnosed globally. There have been at least 1,562 deaths in New York City, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University.
Griggs' "new normal" is a 24-hour shift at Columbia University Medical Center, where she treats patients with COVID-19.
Griggs said she made the difficult decision to move her children from New York City to Connecticut, where her parents could look after them for the time being. Her husband, Rob Goldstone, 36, who is a surgeon at Massachusetts General Hospital and Newton Wellesley Hospital, is fighting the coronavirus pandemic in Boston.
Griggs hasn’t seen her husband or her kids in two weeks.
"My whole family is separated right now, which is really difficult. I don’t know when it will be safe for me to see any of them again, and that definitely takes a toll on my emotional and psychological well-being because my family is my support," Griggs said, adding that she and her family try to stay connected through FaceTime.
Griggs said it was a moment of vulnerability when she took to Twitter and posted a message to her children, which has resonated with parents everywhere.
"[From the post] I heard so many beautiful words and messages of support and community, from people around the world, and it was incredibly inspiring. But I want to be really clear about one thing, which is that many people called me a 'hero' and that is not how I see myself in this moment,” Griggs said. “Quite the opposite actually, I feel very scared."
Working at a hospital amid the pandemic is scary, especially with equipment shortages, Griggs said.
The U.S. has a stockpile of 13 million N95 respirator masks. But the federal government has said up to a billion might be needed over the next six months.
N95 face masks are personal protective equipment used to protect the wearer from the transmission of airborne particles and liquid contamination.
"The impending equipment shortages are very worrisome, not only in regard to PPE [personal protective equipment] … With the surge of patients, many who are critically ill patients, we are facing potential shortages on critical medications to keep patients comfortable and sedated while on the ventilators," Griggs said.
"The uplifting part of working at a hospital is that despite that fear, everyone who is healthy, is showing up to do their job and to support each other and take care of our patients."
Griggs hopes everyone at home can demonstrate bravery modeled by her colleagues by following social distancing rules or showing more kindness toward the vulnerable members of our community.
"As a parent, I hope that we all emerge from this crisis in a better place and use it as an opportunity to recognize that the things that divide us are so trivial in comparison to which unites us and make us similar," Griggs said.
"I hope that the world and the country can rebuild a better home for our children."
BartekSzewczyk/iStock(NEW YORK) -- Barbi Manchester has lived with Lupus for 13 years and has taken hydroxychloroquine to treat it for just as long.
But last month, for the first time since being prescribed the medication, she had trouble getting her prescription filled.
"I've never had any issues," said Manchester, a Lupus Foundation of America advocate and ambassador.
After reaching out to multiple pharmacies, Manchester eventually found one that she said had a limited supply.
The Federal Drug Administration on Tuesday said the country is now facing a shortage of the drugs hydroxychloroquine and chloroquine, noting "a significant surge in demand." This comes after the drugs received substantial attention around the possibility that they could be beneficial in treating COVID-19 patients.
President Donald Trump has touted the potential benefits for novel coronavirus patients, previously saying, "We don't know, but there's a real chance that it could have a tremendous impact."
"It would be a gift from God if that worked," Trump said. "That would be a big game changer. So, we'll see."
The FDA has not approved a specific treatment for novel coronavirus patients, according to the Centers for Disease Control and Prevention.
The Department of Health and Human Services said it accepted 30 million doses of hydroxychloroquine sulfate and one million doses of chloroquine phosphate "for possible use in treating patients hospitalized with COVID-19 or for use in clinical trials."
"Anecdotal reports suggest that these drugs may offer some benefit in the treatment of hospitalized COVID-19 patients. Clinical trials are needed to provide scientific evidence that these treatments are effective," HHS said in a March 29 news release.
Manchester said she now wonders what will happen next if there isn't enough to supply to go around.
"Yes, the coronavirus patients do need to have theirs if it is working, but Lupus patients, we also need this just as much," Manchester said.
The FDA said it's working with manufacturers to evaluate the demand for individuals who are depending on the drugs for other treatments, like malaria, lupus and rheumatoid arthritis, and said using the donated medications is expected to "help ease supply pressures for the drugs."
The agency also said, "All manufacturers are ramping up production, and the agency's webpage displays current availability. The FDA is working with manufacturers to ensure this can happen expeditiously and safely."
The Lupus Foundation of America, American College of Rheumatology, American Academy of Dermatology, and the Arthritis Foundation last month sent a joint letter to the White House Coronavirus Task Force voicing concerns that "increased demand for these drugs attributed to COVID-19 has exacerbated their already limited availability for patients who rely on them to meet their medical needs."
Earlier this week, the Lupus Foundation of America said in a blog post that, "Unfortunately, many people with lupus nationwide are unable to access these much-needed treatments altogether or they are facing other significant obstacles filling their prescriptions."
But added that the group has received "positive responses from federal and state officials and other key stakeholders, including the manufacturers of hydroxychloroquine and chloroquine, state boards of pharmacy, health plans, pharmacies and pharmacists, and physicians -- all of who can play a role in helping to ensure people with lupus have access to the medications they need."
"I've been on the medication for 13 years, so this is like a daily regimen," Manchester said. "It's like people that take a vitamin every day."
"And then having that taken away -- that was very scary," she later added.
microgen/iStock(NEW YORK) -- Lung problems like pneumonia and respiratory failure can be some of the most severe symptoms of COVID-19. Knowing how your lungs are doing could help calm a lot of nerves. Advice found on YouTube and social media is gaining traction, turning some toward the use of a pulse oximeter to monitor their oxygen levels at home.
For people who already have the pocket-sized device at home due to an underlying health condition, it's fine to continue using it -- but doctors say for most people it’s not needed, and may even be a bad idea.
A pulse oximeter, also called a "pulse ox," painlessly clips to your finger and uses light to determine the percentage of oxygen in your blood and your heart rate. The device is typically found in a doctor's office, but some versions are available for sale on Amazon and at medical supply stores. Normally, this information helps your clinician determine if you need supplemental oxygen.
The American Thoracic Society feels most people do not need a pulse oximeter. Some people are prescribed a pulse ox for conditions that cause them to have periods of low oxygen or certain underlying lung conditions, or for when they're exercising or traveling to high altitudes.
If you fall outside of those categories, you can ask your doctor if a pulse ox is something you really need.
Dr. Len Horvitz, an internist and pulmonologist at Lenox Hill Hospital in New York City, said he recommends home pulse oximeters to many of his patients, but noted that for the people without an underlying respiratory disease, they are likely not necessary and may make people anxious if they feel the need to frequently check their oxygen levels.
"Keep in mind a pulse ox is only good if you have the ability to supply supplemental oxygen," said Dr. Eric Cioe-Peña, director of global health at Northwell Health in New Hyde Park, New York. "So it is good for triage for those who are medically frail. But it is not a tool for everyone to have at home because, regardless, if the outcome is your oxygen saturation is low, you will need to go to a hospital."
Having technology available literally at our fingertips doesn’t always mean we should use it.
"You do not need this if you are 30 and have no medical condition," Cioe-Peña said.
Although pulse oximeters are commercially available, they come at many price points and the quality can vary greatly. There is no good way to know whether a home pulse ox is reading accurately. Additionally, the range of what is considered normal can vary from person to person, so the best person to interpret a pulse oximeter reading is a physician.
Having a pulse ox at home may help with your desire to have some control during an overwhelming situation like a pandemic -- but it may also create more stress. If you are short of breath from climbing a set of stairs, you may have not noticed before, but experts worry that people without a medical degree might jump to conclusions.
People can feel short of breath for many reasons, and it does not necessarily mean there is an underlying problem. Horvitz noted if you feel short of breath, there are several ways to determine if your breathing is OK without a pulse ox.
That includes a simple test: Check to see if you are taking 12-18 breaths per minute, which is a perfectly normal range. Alternatively, if you can speak in full sentences and go about your day without feeling short of breath, doctors say you probably have enough oxygen in your blood.
Doctors interviewed by ABC News also cautioned people against buying pulse oximeters due to the ongoing shortage of medical supplies, which are desperately needed in hospital settings.
"As we expand beds in all these acute care areas that we are creating all over, we won’t have these pulse oximeters built into the walls so we are going to need them on these portable devices," Cioe-Peña said. "Having 90% of America order them on Amazon isn’t going to do us a favor."
And even if a home pulse oximeter shows your blood oxygen level is normal, it doesn't necessarily mean you do not have the virus. While shortness of breath and low oxygen levels can be a sign of COVID-19 infection, a pulse-oximeter is not the best way to determine if you truly have it.
If you are concerned about having COVID-19, you should call your primary care physician for guidance on where and how to get tested. If you are having trouble breathing, you should call 911 or head to your nearest emergency room.
Dr. Kyle Annen, with Children's Hospital Colorado. (ABC News)(NEW YORK) -- Doctors at Children's Hospital Colorado hoping to save lives amid a global pandemic are calling on people who have already recovered from COVID-19 to donate their plasma, part of an experimental treatment to help patients who are still sick.
"People who have recovered from coronavirus have a ton of antibodies," said Dr. Kyle Annen, medical director at the Children's Blood Donor Center. "So what we're doing is we're taking the plasma from the people that are just recovered from coronavirus but no longer have the virus, and then transfusing it into people who currently have the virus, but haven't made enough antibodies to defeat the illness yet, in hopes that will help them to kind of get over the hump and start getting better."
The process is called convalescent plasma, a treatment Annen said is experimental, but has shown early promise.
"This is kind of the best option we have," she told ABC News. "Most of these patients are going to be on a respirator or on the verge of needing a respirator, and they really have had other failures of medical treatment. So this really is the last potential opportunity to potentially turn things around for them."
Children's Colorado believes it is the first facility in the state to begin collecting antibody-rich plasma to help battle COVID-19, which it said can be made available to outside hospitals wherever needed.
"The theory here I think is very solid, and so we're very optimistic that this will actually help save lives and help reduce mortality and morbidity," said Jerrod Milton, a senior vice president of operations at Children's Colorado. "That's our sincere hope."
The family of Colorado anesthesiologist Michael Leonard -- fighting for his life and on a respirator in an intensive care unit -- is hoping the treatment will help save him.
His daughter, Molly Leonard, put out a desperate plea for a donor earlier this week.
"He's really sick despite receiving the best health care anyone could ask for. His medical team thinks that he may benefit from convalescent plasma," she wrote on a community website forum.
Leonard told ABC News that her father received a plasma transfusion from a donor on Thursday morning, and now doctors and his family are waiting to see if it works.
The Food and Drug Administration approved emergency investigational use of convalescent plasma on March 24.
"Use of convalescent plasma has been studied in outbreaks of other respiratory infections, including the 2009-2010 H1N1 influenza virus pandemic, 2003 SARS-CoV-1 epidemic, and the 2012 MERS-CoV epidemic. Although promising, convalescent plasma has not been shown to be effective in every disease studied," the agency wrote.
Annen said the FDA requires potential donors to have tested positive for COVID-19. The donor must be recovered, completely symptom-free for 14 days and must take another follow-up COVID-19 test with negative results. Donors must meet all other blood donation eligibility rules as well, Annen said.
Once a donor is approved, Annen said turnaround time is quick.
"Roughly, it takes about 24 hours to get this to a patient," she said.
Annen said there are still some unknowns about the treatment's ultimate effectiveness, and impact on the patient.
"When these antibodies are transfused into the patient, it may cause a little bit of a dampening of the patient's own immune system. So in some ways we're giving the patient antibodies to help them immediately, but it could potentially actually slow down their ability to make their own antibodies," she said. "The general belief is that giving the antibodies is more beneficial than the idea of this possibility. But it is something that we are trying to look at."
Annen hopes that convalescent plasma can be carefully studied to see how well it works against COVID-19 and potential unknown diseases in the future.
"I think that as a physician, and as laboratory technologists and as advanced care providers, it's really our duty to do everything we can to help our patients and to try to get control of this terrible thing that's happening to the U.S. right now, and the world," Annen said.
Children's Hospital Colorado is encouraging people who believe they are a potential donor to call 720-777-3557 or email convalescentPlasma@childrenscolorado.org.
Brendan von Wahl/iStock(NEW YORK) -- Walking the dog has been a popular diversion for many enduring coronavirus quarantine, with pets playing an important role in helping humans get through this difficult time. Shelter-in-place orders around the country have even created a surge in demand for pets to provide both companionship and comfort.
"There is now a huge interest in fostering dogs and cats," said Tracy Elliott, president of the Chicago Anti-Cruelty Society. "We have hundreds and hundreds of people waiting."
Elliott said the society also experienced a run on adoptions before it had to close its buildings.
Elliott points to the numbers. Normally the society might have around 100 dogs in foster care on any given day, but now 214 are being fostered. And their kennel no longer has nearly enough animals to meet demand.
The same story can be found across the U.S.
"We saw a nearly 70 percent increase in animals going into foster care through our NYC and Los Angeles foster programs, compared to the same time period in 2019," the American Society for the Prevention of Cruelty to Animals said in a statement provided to ABC News. "In addition, since March 15, more than 600 people completed online foster applications for our New York City and Los Angeles foster programs, representing a 200 percent increase when compared to traditional application numbers during this period."
Jim Tedford, the CEO of the Association for Animal Welfare Advancement, a professional organization for public and private animal shelters, said he's heard about shelters being "relatively emptied out," because so many people have volunteered to foster or adopt pets.
"I've heard from a number of shelters who actually say they've got a backlog of up to a thousand volunteer foster homes on a list, waiting for animals to take care of," Tedford said.
The "need" element works both ways: More and more animals need caretakers as shelter workers are forced to stay home, so shelters reached out to their respective communities for volunteers to foster and adopt those pets.
But the animals are giving back just as much, fulfilling human needs amplified by social distancing.
Elliott cites "companionship and unconditional love" as "absolutely" among the most valuable benefits offered by pets at this time. Tedford adds another: "Animals force us into a routine," particularly for those not accustomed to working from, or being stuck at, home.
"You don't get to just lay in bed until 11 or 12 o'clock," he said. "You've got to get up to feed that dog or cat. If it's a dog you're more than likely going to have to take him for a walk right away."
These benefits may pale in comparison to another that dogs might provide. A British charity, Medical Detection Dogs, is exploring whether dogs could be enlisted in the fight against COVID-19 using their acute senses of smell.
According to its website, "Dogs searching for COVID-19 would be trained in the same way as those dogs the charity has already trained to detect diseases like cancer, Parkinson's and bacterial infections -- by sniffing samples in the charity's training room and indicating when they have found it."
As to the question of whether pets may be a risk at this time, the Centers for Disease Control and Prevention says, "At this time, there is no evidence that companion animals, including pets, can spread COVID-19 or that they might be a source of infection in the United States."
It seems the biggest "risk" for those taking in animals during the pandemic is that the situation will be more than temporary.
"If history is a guide," Tedford noted, "there is a great chance that a lot of those [pets] will become permanent fixtures in those households."
Courtesy Andrea Pitts(NEW YORK) -- Scars scattered across Andrea Pitts' body may be physical signs of her traumatic experience as an infant, however, for Pitts and for so many burn survivors, emotional scars also linger.
"One day I was looking for something to wear in the closet," Pitts explained to ABC News' Good Morning America, "and I was going through all these different clothes I didn't want to wear them because I didn't want to show my scars."
This closet-searching moment would become a soul-searching moment for Pitts, who said embracing her scars has been a lifelong process.
At just 18 months old, a freak accident in the kitchen left her covered with second- and third-degree burns on 30% of her body. For most of her life, she hid her scars. Growing up, she was taunted and teased, but she also struggled to accept herself.
"Not only is it other people," Pitts explained, "sometimes you can be very unkind to yourself, because it's a challenge for you to see yourself in the mirror. So it has been a journey for me. I have been going through this journey for 30-plus years now, and I have my good days, I have my bad days, but I keep pushing forward."
Today, the Nashville, Tennessee resident is not just pushing forward for herself, but she's bringing others up along the way.
In 2016, Pitts launched her own nonprofit dedicated to embracing those scars, aptly naming it Scars Uncovered.
The name of her nonprofit, Pitts explained, came to her in that very moment when she realized it wasn't the clothes she was struggling with deciding on, it was accepting her own image.
"At that moment, it hit me ... scars uncovered," Pitts revealed. "I want this to be an organization where burn survivors feel like they can be transparent. They don't have to hide. They don't have to not wear what they want to because they're afraid of what people are thinking or they can't accept themselves."
Pitts is helping others embrace their scars and providing vital resources to help those in need through what she calls Boxes of Love, little care packages she delivers directly to burn survivors in hospitals.
"We have care packages that we provide the in-patient [in hospitals] and we always let them know like we are here to support you any way we can," she said.
Inside the care packages, Pitts includes earplugs, an eye mask, pens, journals, a deck of cards, floss and lotion. But that's not all.
"I always make sure that I have a letter, personally from me, just to let each survivor know that you're not in this by yourself," she said.
"I think my favorite item throughout the box is probably our journals," Pitts explained. "Just because it just gives them time to really write their thoughts or even if it's just writing their medical information. They just have some type of outlet to write out their thoughts, how they're feeling, how the journey is going."
"They're very small items that seemed to make a very big impact on the life of patients," she added.
The gifts leave a lasting impact for burn survivors like John Honeysucker, who received a box from Pitts after ending up in the hospital after an accident. The care package, he said, provided some much-needed comfort.
"When she walked in, it was a breath of fresh air," Honeysucker said. "Even the products that were in it, some things that I don't even use, you know, even though I didn't use playing cards, but guess what, it gave me something to look forward to, because when I tell you you're sitting there feeling hopeless and helpless ... and to receive that box, it made you feel your self-worth really is restored."
In addition to distributing Boxes of Love, Scars Uncovered has assisted more than 1,000 adult and pediatric patients. Pitts works annually with Nashville firefighters to help burn survivors, and prior to the coronavirus outbreak, would go directly into hospitals in the Nashville area to do those personal drop-offs. She also hosts fundraisers to raise money to purchase the supplies she needs for the care packages.
At the end of the day, for Pitts, it all comes back to love.
"A lot of the times we [judge] ourselves so much on the outward appearance," Pitts shared in her message to other burn survivors. "And that can be very hurtful sometimes. But remember who you are on the inside and just know that you will get through this one day at a time."
Zach Branson(WHITEWATER, Colo.) -- Zach Branson was born with a rare liver disease. Doctors recently told Branson, a 33-year-old living in Whitewater, Colorado, that he wouldn’t survive much longer without a liver transplant. In a stroke of good luck, his uncle volunteered to be a living donor.
“Everything was finalized,” Branson said. “His liver was a great matchup for me.”
But in March, as the COVID-19 pandemic swept the country, Branson’s doctors postponed the transplant.
“I should essentially be in transplant surgery right now, but I'm currently not because of the pandemic that's going on,” Branson told ABC News on March 25.
Doctors across the country are making the difficult decision to postpone some major surgeries for several important reasons, according to Dr. Marc Boom, CEO of Houston Methodist Hospital.
“We want to free up beds for the potential surge of patients with [COVID-19],” Boom explained, saying hospitals also aim to “conserve our personal protective equipment,” like surgical masks and gloves. Boom said another important goal is to “decrease the traffic flow, honestly, of people coming in and out of the institution.”
Branson just received good news about his transplant: surgeons are rescheduling his surgery in order to get it done now before there is a peak of COVID-19 patients. Branson admits he is "a bit nervous" about the added risk of becoming infected with the virus, but said he was "quite resilient."
Medical professionals say they may have their patients’ health in mind when making the decision to postpone major procedures – but for patients like Larry Motto from New Jersey, whose kidney transplant was just placed on hold, it’s disappointing all the same.
“It was not a happy time because we have not had the easiest time in the past four years finding a match,” Motto said.
“It's hard when you've been waiting and you were so close. It was like there was the light at the end of the tunnel...and everything was taken away from us,” said Motto’s wife, Rebecca.
She added, "It was quite heartbreaking when we found out that it was cancelled but at the same time understandable with everything that was going on with the coronavirus."
Sherrie Kumm, a 33-year-old teacher’s assistant in Washington state, suffers from severe seizure disorder. When her doctors decided to postpone Kumm’s brain surgery, people in her community rallied to support her.
“My students had given me little cards, saying ‘I hope your surgery goes well,” Kumm said. “We love you and we’ll miss you.’”
For patients like Kumm, sometimes the waiting is the hardest part. “[My] whole family is now waiting. It’s like we're at the airport, you know, flying, standby.”
Cancer patients are another vulnerable population struggling for treatment during the pandemic. Alyson Vitticore, a Brooklyn native who temporarily moved to Buffalo, New York, is battling stage IV breast cancer. She just decided to reschedule surgery originally planned for April to remove her ovaries.
“We're being forced to make a lot of choices that we don’t know [are] right or wrong,” Kumm said.
Even for patients who are in good health, like expectant mother Jennifer Schleyer from Pennsylvania, the risks of contracting COVID-19 has amplified their anxieties and changed their routines. Schleyer and her husband, Blake, welcomed their new son Jackson shortly after their interview.
“Probably the scariest thing in all of this is just how small and fragile Jackson will be,” Schleyer said.
Due to new rules stemming from the pandemic, Schleyer’s 2-year-old son Brody wasn't allowed to visit his newborn sibling in the hospital.
“It’s such a big moment and I just want to share it with my whole family so it’s hard,” Schleyer said.
A longer wait for critical medical procedures may be a hard pill to swallow, but it’s an important step in protecting all patients as the country grapples with the pandemic, according to Boom.
“This is a community-wide effort to make sure that we have a controllable rate of increase in the [COVID-19] infection so that that capacity is always there for everybody, and we can manage this together,” Boom said. “It really is a team effort across our entire community.”
SDI Productions/iStock(WASHINGTON) -- The Food and Drug Administration on Thursday said it would loosen some of the restrictions that have blocked gay men from donating blood.
The agency is changing the recommended deferral period from 12 months to three months.
"LGBTQ Americans can hold their heads up today and know that our voices will always triumph over discrimination," GLAAD President and CEO Sarah Kate Ellis said in a statement. "This is a victory for all of us who raised our collective voices against the discriminatory ban on gay and bisexual men donating blood. The FDA’s decision to lower the deferral period on men who have sex with men from 12 months to 3 months is a step towards being more in line with science, but remains imperfect. We will keep fighting until the deferral period is lifted and gay and bi men, and all LGBTQ people, are treated equal to others."
iStock/Prostock-Studio(CHICAGO) -- On a normal Thursday night, 29-year-old Chris Reed and more than 100 recovering alcohol and drug addicts like himself would be filling The Other Side sober bar he opened in northern Illinois to listen to live music, socialize and lean on each other in their daily struggles to keep from relapsing.
But since the coronavirus has swept the globe killing more than 50,000 people, including more than 5,000 in the United States, Reed's sober tavern in Crystal Lake has been shuttered by social distancing rules and all-important physical peer-to-peer meetings for people in recovery have switched to online virtual gatherings.
"I got sober in 2009 from opioid addiction. I just celebrated 10 years in September," Reed told ABC News. "For me, I got sober at 19 and I thought I was the only person who had these issues and then I started going to meetings and I started to see all these other people who had gone through similar things and connecting with them, whether it was just going out to dinner or coffee after a meeting. There was a certain level of camaraderie. That’s just something you can’t produce with the Zoom meetings."
Reed also runs three New Directions sober houses in his community and the Northern Illinois Recovery Center, where in recent days as the virus has spread across the Prairie State he says he's seen an uptick in the number of people new to recovery straining to stay sober.
"It’s hard enough to make that first decision and say, 'Hey, I’m going to change my life, I’m going to try and get sober.' For all that support to not be as robust and effective as is normally sucks, for lack of a better term," Reed said. "It’s just not the same. There are a lot of struggles."
Dayry Hulkow, a primary therapist at Arete Recovery center, a Delphi Behavioral Health Group facility in Pembroke Pines, Florida, said her organization has seen a significant spike in relapses as stress mounts on people in recovery coping with skyrocketing unemployment and being isolated with family members getting an up close and stark picture of the demons they are battling.
A 2018 national survey on drug use and health by the federal Substance Abuse and Mental Health Services Administration, an arm of the U.S. Department of Health and Human Services, found that 14.8 million Americans, some as young as 12, had alcohol use disorders while another 8.1 million were battling illicit drug use disorders.
Hulkow said she fears the numbers will only get worse as the pandemic grows and puts up roadblocks to recovery services.
"We have already seen relapses happening, moments of crisis, obviously a lot of mental health issues associated with the addiction and all the stresses that are going on in the world," Hulkow told ABC News. "I’m definitely afraid that the numbers are just getting started now."
She said the void of direct access to social support networks, including going to meetings and being in face-to-face contact with supportive friends "is a huge trigger for relapse."
"Also there is the boredom, having to stay at home with very limited access to the outside world, hobbies meetings and employment. All that kind of stuff, it’s a significant trigger as well," Hulkow said. "Then for those that do have family at home, a lot of times family could ... lead to disputes in the home. Being confined in such a small area without any outside release could also be a trigger for relapse."
Hulkow advised people struggling with recovery to stay in contact with their support groups by phone and to take advantage of virtual meetings offered online.
"Know that there is hope, that this is temporary. This situation is definitely going to pass. We don’t know how or when, but it will pass," Hulkow said.
"The biggest part is trying to maintain a routine as normal as possible," she added. "I know there are many abnormal things about the current situation, but trying to at least stick to our basic routine, which is sleeping times, meal times, self-care time, if there’s exercise, yoga, certain hobbies that we still have access to. Trying to surround yourself with as much positive activities and normalcy within our lives can definitely be very helpful."
In response to the global outbreak, Alcoholics Anonymous chapters worldwide have turned to holding A.A. meetings on video conferencing websites like Zoom and Google Hangouts, or conducting conference calls.
"While we do recognize that for some A.A. members, meeting online may be an adjustment, our experience to share is that from A.A.’s earliest beginning. A.A. membership and recovery has not been contingent upon meeting 'in-person,'" reads a statement from the the General Service of Alcoholics Anonymous, a repository for A.A. members and groups looking for information on meetings and other ways to connect.
"Even prior to this global pandemic, many A.A. members around the world whether homebound, living in remote areas, including Service Members on ships have had meaningful recovery through accessing A.A. literature, letter/email correspondence, phone calls, and online/phone meetings," the statement reads. "Amid coronavirus (COVID-19), though many A.A. members are for the first time, after years of attending in-person meetings are having to learn to adapt to digital platforms, for many alcoholics around the world this is how they have found and maintained recovery in A.A. even before this pandemic."
M.J. Gottlieb, a recovering alcoholic from New York City, said he celebrated his eighth year of sobriety on March 21, one day before Gov. Andrew Cuomo issued a statewide stay-at-home order in an attempt to blunt the spread of the virus -- which as of Thursday had killed more than 2,300 people in the state, including nearly 1,400 in New York City. In November 2018, Gottlieb, an entrepreneur who has owned and operated several clothing brands, launched Loosid, an app providing a platform of hotlines and online or services to break the stigma that sobriety "means the end of fun."
"I had been trying to get sober for many many years and I would invariably find myself at coffee shops and diners. I said to myself, if this is all there is then I’m going to continue to use, which I did for the next 15 years," Gottlieb told ABC News, adding that before the pandemic struck Loosid was introducing people to things like sober travel and restaurants offering sober cocktail or "mocktail" hours.
Since the first week of March, Gottlieb said Loosid has seen a 93.8% increase in monthly active users taking advantage of its online services like mindful meditation and yoga classes.
"There’s about 60,000 people using the platform right now," Gottlieb told ABC News.
He said many people have been using the app's "sober curious" group, where people who suspect they are developing a substance or alcohol abuse problem can find information and seek help. He also said he has seen a 620% increase in dating messages sent.
"I thought this was going to tank, but what I’ve realized is that people are lacking intimacy," Gottlieb said. "People are now reaching out and actually having conversations because they can’t jump out to a restaurant and meet a person right away. So, we’re actually able to give people some level of intimacy to connect with people that they’ll connect with in the future once we are back to the regular speed we were at before COVID."
Back in northern Illinois, Chris Reed said he's been spending hours on the phone with people in recovery and trying to keep those at his sober houses and recovery center stay strong.
"I think the consistent message that we’re giving is, ‘Hey, look at this as an opportunity to focus on yourself because there’s nothing else that you have to do," Reed told ABC News. "You don’t have to be looking for work right now, you don’t have to be doing anything else except for this internal work.”
AlxeyPnferov/iStock(NEW YORK) -- An ABC News investigation offers sobering insight into how COVID-19 has spread and penetrated so broadly, so deeply and so quickly in the United States. It also helps explain why Americans, no matter where they live, must continue to heed the warnings of health officials to self distance and why the virus likely was here far earlier than first realized.
With the advent of COVID-19, the world has officially entered a dangerous new phase where a surge in international travel in recent decades served as the springboard -- jet fuel, really -- for an infectious disease potentially to kill hundreds of thousands in the U.S. and infect the global economy at breathtaking speed.
As New York Gov. Andrew Cuomo put it, "I have no doubt that the virus was here much earlier than any of us know, and we have the virus more than any other state because travelers from other parts of the world come here first."
Travel data of passengers arriving in the United States from China during the critical period in December, January and February, when the disease took hold in that country, shows a stunning 759,493 people entered the U.S.
"This is an astonishing number in a short period of time, illustrating how globalized our world has become. Just as people can hop continents with amazing ease, the infections they carry can too," said Dr. Vinayak Kumar, an internal medicine resident at the Mayo Clinic and a contributor to the ABC News Medical Unit.
Those travelers from China included more than 228,000 Americans returning home and hundreds of thousands of Chinese nationals arriving for business, academics, tourism or to visit family.
"The numbers are clearly alarming," Dr. Simone Wildes, an infectious disease specialist at South Shore Health, told ABC News. "It shows that globalization is here, and we have to be better prepared to deal with the impact this will have on all our lives in so many ways."
Added Wildes: "It is difficult to estimate the portion of travelers coming from China to the U.S. with COVID-19, but fair to speculate that a large number might have been infected at the time of travel."
While the majority of the travelers likely went to major population centers like New York, Seattle or Los Angeles, with so many arriving, any of the hundreds of thousands could have gone anywhere in the U.S.
Researchers from Johns Hopkins University said the outbreak could have started as far back as November, and that there may have been hundreds of cases in Wuhan by early December. On Jan. 14, a different team of researchers from the University of Toronto warned that the outbreak could quickly jump from Wuhan to other major cities because of international travel.
President Donald Trump restricted travel from China effective Feb. 2, which likely saved lives. But by the time the president acted, much of the damage had already been unleashed, and some 18,000 Americans returned home from China in February and March, after the restrictions were in place. It's unclear how intensive, if at all, the screening was for the Americans coming home at that point.
"The United States banned travel to China 12 days after the world heard there was an outbreak of severe pneumonia in Wuhan. ... The problem was, it was too late," said Dr. Todd Ellerin, chief of Infectious Disease at South Shore Health and an ABC News Consultant. "Even though there had only been 12 confirmed cases in the U.S. on the day President Trump announces the travel ban, the reality was there were many more unconfirmed cases."
The data, gleaned from Commerce Department records and additional information compiled by U.S. Customs and Border Protection at the request of ABC News, represents the most detailed accounting yet of travelers coming into the U.S. from China and other countries where the virus quickly spread.
ABC News examined data from December, January and February on travelers entering the U.S. from eight of the hardest-hit countries: 343,402 arrived from Italy, 418,848 from Spain and about 1.9 million more came from Britain.
Combined with those from China, that's more than 3.4 million people from just four countries -- nearly half, about 1.5 million, Americans returning home. Travel from Italy and Spain wasn't shut down until March 13, with U.K. arrivals restricted a few days later.
The data shows how a highly communicable disease can quickly move throughout an interconnected global community, spreading across the globe in a matter of hours. The novel coronavirus was off to the races before the international community knew what had hit it.
"I think this was bound to eventually happen," Kumar said. "The high volume of international travel, the lack of screening, the inconsistent hand-washing and cough control ... these laid down the perfect conditions for a disease to spread. Add that to a virus that is both largely asymptomatic and has a prolonged infectious period, and you have got a perfect storm of factors for a pandemic."
The world simply wasn't ready, even though scientists and medical experts had long warned of such a possibility.
"This is not new," said John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News Consultant. "We've seen this with H1N1, SARS, Zika. We should have had the infrastructure to prepare for this. And we didn't.
"There was a lack of recognition that a coronavirus emerging in a market in Wuhan could be at our door in a matter of months. Now that it's hitting the U.S., for the first time really, people are aware of the interconnection and risk."
Medical experts who spoke to ABC News said it can't be known exactly how many of these travelers were infected or contagious, but that it's highly likely some portion carried the virus without exhibiting severe symptoms. Minor symptoms, including coughing, sneezing or a runny nose, may have been ignored, leading to people unknowingly spreading COVID-19.
The novel coronavirus "is extra complicated because of mildly symptomatic and asymptomatic transmission, which made it much more difficult to contain," Brownstein said. "We were caught flat-footed."
Among the millions of travelers likely were a number of biological ticking time bombs, passengers who'd later infect others at a rate at least double that of the typical flu carrier.
"SARS-CoV2, the virus that causes COVID-19, the most disruptive infection the world has seen in the last 100 years, has some features that make it impossible to completely contain," Ellerin said.
It's time for governments to rethink how to mitigate the emergence of superbugs, experts told ABC News.
"We should recognize that any time there is an emergent event, there is a very good opportunity for global impact," Brownstein said. "We need to be thinking about emergent diseases as a global concern rather than [something] happening in a particular part of the world."
Additionally, there have been questions and criticisms about how quickly China alerted the international community, given the extraordinary scale of travel in and out of the country. Questions also have been raised about the Trump administration's public stance and early response -- was the U.S. aggressive enough early on, given the travel numbers? It's unclear how closely policymakers and health experts weighed the data -- or whether they had access to the data.
Political, business and health leaders now working together to battle COVID-19 risk a repeat of the pandemic without newer, better measures implemented going forward, experts said. That could include more infrastructure, more medical equipment and doctors at airports, new methodologies never before considered necessary: routinely checking passengers' temperatures, en masse or individually, using quarantine facilities at transportation hubs or storing gloves and masks on planes to be used by people feeling ill.
"This could be an opportunity for countries to provide rapid response to catastrophes and exchange ideas and information, given the advances in technology," Wildes said. "The medical advances in one country can be shared with other countries that will aid in the management of their patients and possible impact on their health care system. Researchers around the globe can work on the same problem with the aim to find treatment for a vast number of patients at the same time. This can serve as a early warning for other countries."
Wildes said, bottom line, it's all about cooperation: "We should realize that we are all in this together. We are all at risk of being exposed to the virus, so let us fight together so we all can be healthy together."
But there are no easy answers.
"Could China have announced to the world a couple of weeks earlier that there was concern that a SARS-like outbreak was occurring? Possibly," Ellerin said. "Could an immediate travel ban announced by China have slowed the spread of this virus even further? Likely. But, in the end, given the complexities of global travel and the insidious nature of this virus, even an immediate travel ban probably would not have fully contained this contagious pathogen."
In other words, the world had better get creative -- and fast.
New York City surgeon Dr. Craig Spencer discusses his concerns about COVID-19 outbreak on "The View," April 2, 2020. - (ABC)(NEW YORK) -- A surgeon who was the first person in New York City to be diagnosed with the Ebola virus in 2014 rejected President Donald Trump's claim that masks and other protective equipment intended for use in New York hospitals to fight the novel coronavirus, COVID-19, might have been stolen.
Dr. Craig Spencer, the director of global health and emergency medicine at Columbia University Medical Center is on the frontline of the COVID-19 fight in New York City, which has been considered the epicenter of the pandemic in the United States.
During a briefing on Monday morning, Trump responded to an account by a mask company executive who said the demand for masks had skyrocketed at one unnamed New York City hospital from between 10,000 and 20,000 masks a week to between 200,000 to 300,000 a week. Trump insinuated that people might be taking masks from the hospital "out the back door."
"Where are the masks going? Are they going out the back door? How do you go from 10,000 to 300,000? And we have that in a lot of different places," Trump said without mentioning any specific examples of hospitals reporting lost masks or ordering large amounts of them.
State officials across the U.S. have criticized the federal government for not providing enough supplies. With shortages, nurses and doctors have resorted to reusing protective equipment, accepting donations, buying their own personal protective equipment (PPE) and other workarounds to keep themselves safe.
The New York Greater Hospital Association and New York Governor Andrew Cuomo have since pushed back on Trump's claims.
Spencer responded to the president's remarks on The View Thursday.
"I don't see anyone running off with a ventilator or with masks," Spencer said. "I see everyone running into the hospital to help out."
"The only thing that I've seen is all of my colleagues, not only at my hospital but all around the city, just stepping up, working extra shifts, doing whatever they can to provide the best patient care," Spencer continued. "What I'm seeing is people show up and use that personal protective equipment to keep them safe and do everything they can so that they can stay at the frontlines."
Several states have sounded the alarm over a lack of ventilators for hospitalized COVID-19 patients, including a plea from Cuomo for 30,000 machines.
Spencer said "we all have concerns" about the number of ventilators and masks available.
"Health care workers are much more susceptible to this virus," Spencer said. "We're doing everything we can to be there and be present every day to stay safe and provide that high-quality care."
Spencer said the country's lack of preparedness for a pandemic "is really frustrating." Although planning for a pandemic is "expensive," he claimed it would have cost less than the $2 trillion stimulus package Trump signed into law Friday.
"I'm really concerned. Many of us, many of my colleagues, myself included, have written articles in the past couple of years worried about what's going to happen when we see a pandemic here," Spencer said. "Unfortunately, we're seeing that impact."
When it comes to COVID-19 testing, Spencer said that the fact that so many people are going untested is "a huge issue" and that it can "have an impact in our ability to know how prevalent the disease is; to know how it's spreading."
"It really did leave us behind the curve," he said.
Spencer's "concern right now" with COVID-19 is that the U.S. "didn't take it seriously early enough."
"We were warned by China and we didn't react. We were warned by Italy and we didn't really prepare," Spencer said. "People aren't taking it serious, even as it starts to spread across the rest of the country."
"If there's one message that I can share, it's that this is really real and it can take anyone down," Spencer said. "Young or old, no matter where you are, whether you're a Democrat or a Republican, it doesn't care. The only bipartisan thing right now in the country, it seems like, is our susceptibility to getting infected with coronavirus."
Memorystockphoto/iStock(NEW YORK) -- Masks are at the forefront of people’s minds as health care workers continue to face shortages during the coronavirus pandemic. Together with disinfection and hand-washing, N95 respirators have proven to reduce the infectious risk of COVID-19 in doctors and nurses.
N95 respirators are tight-fitting masks that filter out 95% of particles in the air and reduce exposure from small particle aerosols to large droplets.
In order to wear an N95 respirator effectively, achieving an adequate seal is essential. United States regulations mandate that health care workers get fit-tested every year, a process that involves spraying foul-tasting fumes around a person's head to see if the mask successfully blocks particles from entering the nose and mouth.
According to the Occupational Safety and Health Administration (OSHA), the test won’t be conducted if there is any hair growth (stubble, beard, mustache or sideburns) between the skin and the face piece sealing surface. That means anyone who plans to wear an N95 mask would need to shave their beards to ensure a good fit.
Eric Cioe Peña, MD, MPH, FACEP, director of global health at Northwell Health in New Hyde Park, New York, explained that "hair under the edge of the mask breaks the seal and makes it useless." As with many others on the front lines of battling COVID-19, Dr. Cioe Peña shaved his beard to get fitted for an N95.
Dr. Alina Bridges, associate professor of dermatology and pathology at the Mayo Clinic said that her institution updated their "no facial hair" policy. Effective immediately, "staff are required to be clean shaven for fit testing."
Hospitals have policies in place granting religious exemptions to shaving. For those who cannot shave or perhaps have "some structural abnormality or some respiratory [compromise] that prevents them from using these respirators," they can use powered air purifying respirators (PAPRs) -- but those are in short supply and cumbersome to wear.
For health care workers shaving their beards for the first time in years, frequent shaving can have downsides, particularly for those with coarse hair or prone to ingrown hairs, explained Houston-based board certified dermatologist Dr. Moneé Thomas.
Her advice is to apply "a warm, wet towel to the beard for a few minutes before shaving to open pores and make it easier to release ingrown hairs. Use shaving gel, shave with a single blade razor or an electric razor on the highest setting. Appling a 1% hydrocortisone immediately after shaving can greatly reduce irritation, she says. And above all: don’t pick at those ingrowns."
Even people without facial hair can develop skin irritation after long periods of wearing an N95 mask. New York-based board certified dermatologist, Dr. Whitney Bowe explained that "abrasions from speaking, mechanical tensions and friction causing a breach in the skin barrier,” which can lead to infection.
The skin, the scalp and beard, all have a microbiome, Dr. Bowe explained.
"The microbiome is the healthy bacteria that is there, our tiny warriors,” she said. “We need to fight the bad bugs and do everything to preserve to the delicate balance of the good bugs.”
Dr. Bowe recommended gently washing the face with soap and water, patting dry, not rubbing, then applying a healing balm.
"I love medical grade honey -- it is amazing for wound healing and natural. It goes through a special pasteurization process in the lab that kills off the bacteria. You can also use aloe, right from the plant, or cream or ointment. Yogurt, avocado, oatmeal, all very calming," Bowe advised.
While the The Centers for Disease Control and Prevention recommends N95 respirators for those on the front lines of the pandemic, what about everyday people and N95 masks? Should everyone shave their beards?
The CDC suggested that loose-fitting surgical masks can be worn by everyday Americans if they feel sick themselves, or if they are caring for a family member or loved one who is sick. Surgical masks help prevent contamination when a person coughs or sneezes.
Unlike N95 respirators that require a close shave, surgical masks don’t.
And having a beard or facial hair does not "trap" the virus closer to your face. Dr. Thomas explained that "the beard shares much of the same flora as facial skin. Therefore, most of the same precautions we take with our face to keep it clean and healthy should also apply to the beard.”
What does all of this mean? For now, shaving is recommended if you need to wear an N95 respirator and not a surgical mask.
art Photo/iStock(NEW YORK) -- As Los Angeles Mayor Eric Garcetti Wednesday recommended citizens to wear face coverings while in public amid coronavirus, medical professionals are weighing in about the benefits of wearing them.
“At this point, there really seems to be no question that everybody should be wearing a mask to protect themselves and more importantly, to protect their community,” Jeremy Howard, research scientist at the University of San Francisco said. “When you’re talking bits of saliva come out of your mouth, you don’t even see them.”
While the use of masks becomes the new normal and medical professionals like Howard recommend to use them while in public, the reality is that it is almost impossible to find just one to purchase.
But experts say that you can still protect your face with other types of face covers even if they are non-medical grade. In fact, it’s what officials like Garcetti emphasized.
“Do not take N-95 masks,” said Garcetti during a presser in Los Angeles Wednesday evening. “They are reserved for front line workers.”
“You are not doing surgery at home or during your shopping. So you don’t need these masks,” said Howard. “They are harder to fit. They are less comfortable.”
Instead, a piece of fabric made with cotton or an old sheet would work just fine. Howard also recommended a bandana or a scarf -- any material that will allow you to breathe while wearing it. A plus is if the material is able to stop liquid.
Here are some tutorials to make a face cover:
For the proficient sewer, a basic pattern involves two layers of fabric, three folds and elastic to go around the ears. You can either use a sewing machine or hand sew the face cover together -- it might just take a little longer. Deaconess Hospital provides instructions on how to make a face covers with ties on their website.
Another tutorial shows that you can forgo sewing by cutting up an old t-shirt together and tying the ends together.
Or if you are in a pinch and sewing is not your thing, a simple bandana with two hair ties works perfectly.