(MONTGOMERY, Ala.) -- As coronavirus cases in Alabama prisons continue to rise, the state Department of Corrections is offering incarcerated individuals incentives to get vaccinated.
Both inmates who get the vaccine and those who've already gotten it will get $5 in canteen credit.
The initiative comes as the Alabama Department of Corrections reports a total of 27 people -- nine inmates and 18 staff members -- tested positive for COVID-19 last week, more than four times the amount of cases reported the previous week. The department said no inmates have participated in the prison's free vaccination program since July 23, and the vaccination rate for Alabama inmates inside correctional facilities is 62%.
"A confined correctional environment in which social distancing is challenging and all communicable diseases, to include COVID-19, spread more easily is -- put simply -- starkly different than a community environment," department spokesperson Kristi Simpson told ABC News, adding that incarcerated people don't have the "freedoms available to free citizens to ensure public safety."
Along with this new initiative, Alabama correctional facilities have taken other measures to decrease infection rates, Simpson said, including restricting visitation and non-essential entry into facilities, quarantining new inmates and rescheduling non-emergency medical appointments.
Alabama isn't the first state to offer incentives to incarcerated individuals. The New York State Department of Corrections and Community Supervision randomly selected vaccinated individuals to receive a care package valued up to $75 last month. In Pennsylvania, inmates were offered $25 in commissary credit.
Forrest Behne, policy director at the COVID Prison Project, an organization dedicated to tracking COVID-19 data and policy in correctional facilities, said that while incentives can help increase vaccination rates, the "high prioritization of vulnerable individuals and early vaccine distribution is really essential."
"It's not nothing. Right?" Behne told ABC News of the Alabama incentive, though he also noted that it's "not as generous" as some other places. "We want to see as many people afforded the opportunity to take a vaccine as possible."
Prisons aren't the only entities in Alabama trying to incentivize its community to get the jab. Auburn University rolled out its own vaccination program, offering big-ticket items such as a $1,000 scholarship, priority class registration and a lunch for four with Auburn President Jay Gogue.
President Joe Biden endorsed offering incentives in a briefing last week, encouraging states to use federal COVID-19 relief funds to provide $100 payments to individuals who get vaccinated. States such as Ohio and New York have adopted this approach, but it's unlikely Alabama will follow suit.
Alabama Gov. Kay Ivey has continued to say there is no need for a statewide incentive program for all residents.
"Let's focus on encouraging people, educating people about the benefits of taking the shot," she said during a press conference last week. "That's all we need to do."
In a statement to ABC News, the Alabama Department of Corrections said it and its representatives “stand behind Governor Ivey and her statements.” When asked about the different approaches to increasing vaccination rates, the department added, “Governor Ivey recognizes that measures appropriate to advance the administration of the COVID-19 vaccine within a correctional environment are different than those most appropriate for the general population.”
Dr. Karen Landers, area health officer with the Alabama Department of Public Health, told ABC News the department is still researching available options for the use of federal funding to provide vaccination incentives.
According to the CDC, 34.3% of Alabama's population is fully vaccinated and 43.2% have received one dose.
"I just want to let you know, I just went to see ... my amazing dermatologists and doctors, and they saw something that was a little irregular," the Greatest Showman star explained while indicating to his bandaged nose. "So they took a biopsy, and they’re getting it checked."
Jackman, 52, thanked fans for their concern and assured them they need not "freak out," promising to keep everyone updated.
"They think it's probably fine," he continued. "But remember: Go and get a check and wear sunscreen. Don't be like me as a kid, just wear sunscreen."
The actor revealed in a 2015 interview with ABC News that he spent most of his childhood playing in the hot Australian sun and neglected to wear sunscreen. He was diagnosed with basal cell carcinoma, a form of skin cancer, in 2013.
In the years since, Jackman continued to remind fans of the importance of sunscreen and revealed in 2016 that he had to undergo another biopsy.
"An example of what happens when you don't wear sunscreen. Basal Cell. The mildest form of cancer but serious, nonetheless. PLEASE USE SUNSCREEN and get regular check-ups," he wrote at the time.
In 2017, he shared a similar message about his ongoing battle with skin cancer and credited his "frequent checks" for catching it early.
The Mayo Clinic says basal cell carcinoma is believed to be caused by long-term exposure to UV sunlight and says the best way to prevent it is to wear sunscreen.
(NEW YORK) -- While states like Missouri end a second month enduring a surge in COVID-19 cases as the more contagious delta variant spreads, public health officials across the country are hearing the same story from an increasing number of people getting the vaccine: someone they know recently caught the virus and the experience was unsettling.
"We don't want to see more people getting sick as a driving force to get people vaccinated, but we know the case counts and more people in the hospital will play a role in that conversation," Dr. Sam Page, St. Louis county executive, told ABC News.
Missouri has seen an increase of nearly 560% in new cases, 205% virus-related hospitalizations since early June -- staggering increases, which have been exacerbated by the low number of residents -- just over 41% -- who are fully vaccinated.
"We really need higher vaccination penetration in our communities to slow this down," Page said.
However, Missouri is one of the many states in the nation which has experienced a significant, newfound demand for COVID-19 vaccinations in the last several weeks. Vaccinations statewide increased by approximately 100% in the last two weeks of July.
While the uptick in shots has been most notable in the states that have been recently hardest hit by the coronavirus, the entire country is experiencing a rising vaccination rate.
According to an ABC News analysis of Centers for Disease Control and Prevention (CDC) data from the last three weeks, every state has reported an increase in its average number of first doses administered, with the national rate of Americans receiving their first dose up by more than 73%.
Similarly, in the last week alone, vaccination rates have increased by nearly 20% in young Americans, ages 12-17, and by more than 25% in adults.
And on Sunday, the White House reported more than 800,000 vaccine doses administered, including first and second doses, marking the fifth consecutive day with more than 700,000 doses were reported administered. The uptick pushed the national vaccination average to more than 637,000 doses administered each day -- up by more than 24% in the last two weeks.
There are many factors at play -- fear of the delta variant, incentives from the government and the rising popularity of vaccine requirements for school or work -- but regardless of why it's happening, Page said the increase in vaccinations could not come soon enough.
"The delta variant is a whole new virus," Page said.
Slowly but surely, officials have started to see their public urgings translate into shots in arms, data showed -- a sobering silver lining to the immeasurable grief that has accompanied the virus.
But Page urged other states and counties to get ahead of the delta variant while they could, pulling out every stop to increase vaccination rates before the virus hits their community, because when it does, it's too late.
The uptick in vaccinations in Missouri, for example, will only begin to give ample protection beginning around September, since full vaccination requires two shots and then about two weeks for the antibodies to kick in.
"We just wish that we could get people vaccinated sooner because the illness has an unfortunate loss of life associated with it. And that's just a terrible thing to watch," Page said.
In the final weeks of July, 14 states saw an increase of 100% or more in their first-dose average. All of those states have vaccination totals below the national baseline of eligible Americans who have had one at least shot -- 67.6%.
The five states which have seen the most significant increases in their vaccination rates -- Louisiana, Alabama, Mississippi, Arkansas and Oklahoma -- are also among the states with the current highest seven-day case rates per capita. Louisiana, which currently has the nation's highest case rate, has experienced a nearly 335% increase in individuals receiving their first vaccine dose. Similarly, Arkansas, which has the nation's second highest case rate, has seen a 193% increase in recent weeks.
"This increase in vaccination rates in states that have been lagging is a positive trend. Americans are seeing the risk and impact of being unvaccinated and responding with action. And that's what it's going to take to get us out of this pandemic," White House COVID-19 coordinator Jeff Zients said Monday at a briefing with reporters.
But experts caution that it will be critical for this trend to see even greater increases for the country to avoid more unnecessary hospitalizations and deaths.
"While the increasing caseload has had an impact on vaccine uptake, it has been minor, relative to the need," Maureen Miller, professor of epidemiology at Columbia University's Mailman School of Public Health, told ABC News.
"Since the delta variant is so much more contagious, we'll need to see more people vaccinated to get this pandemic under control -- in the range of 85%-90% of the population."
The introduction of the delta variant, which now results in 8 out of 10 new cases in the U.S., has resulted in a rapid and significant increase in infections across the country.
The United States' daily case average is now up to more than 72,400 cases a day, a 532% increase since mid-June. On Friday alone, the country recorded more than 100,000 new cases, marking the highest single-day report in nearly six months.
Nationally, as of Friday, nearly 40,000 patients were receiving hospital care across the country, up nearly 190% increase in the last month.
Several states with the lowest vaccination rates are now seeing viral surges equal to or higher than the peaks they experienced last winter and spring.
"The combination of the new, highly transmissible delta variant and the lack of both vaccination and implementing preventive behaviors, such as mask wearing and social distancing, have ensured that the unvaccinated will continue to become infected, hospitalized, and a needless amount will die," Miller said.
In Louisiana -- reporting the nation's highest case rate -- the average number of first doses administered has tripled over the last three weeks.
"My hope and my prayer today, is that that slope -- that trajectory of increases in vaccinations -- will continue for a long period of time. Because when that happens, you will see that case growth lines start to come down," Louisiana Gov. John Bel Edwards said.
Edwards on Monday imposed an indoor mask mandate congruent with case numbers climbing and the CDC's most recent mask guidance for everyone, including vaccinated people, to mask up if they're in areas with a lot of transmission.
Health experts like Miller praised the increased restrictions, since mandating vaccines -- considered to be the most effective way to reach herd immunity -- isn't currently an option.
"A current stumbling block to mandating vaccines is the (Food and Drug Administration) emergency use authorization status. Once the FDA provides full regulatory status, that will provide strong legal cover to institute mandatory vaccination," said Miller.
But a piecemeal effort to mandate vaccines is underway, and quickly gaining momentum as the spread of the delta variant grows. The American Medical Association (AMA) and the American Nurses Association (ANA) joined up with over 50 other health care organizations to call for mandatory vaccinations within their industry last week, citing rising COVID cases and the delta variant as reasons.
"Due to the recent COVID-19 surge and the availability of safe and effective vaccines, our health care organizations and societies advocate that all health care and long-term care employers require their workers to receive the COVID-19 vaccine," the organizations wrote in a joint statement.
And last week, the U.S. government announced that federal workers must receive the COVID-19 vaccine or contend with regular testing. The announcement came as a growing list of companies are requiring shots for employees, including Walmart, Google and Disney, ABC News' parent company.
Vaccination is the "primary way" to move out of the pandemic, the AMA wrote, without having to revert to state lockdowns and additional mitigation measures.
"This surge was preventable. Unfortunately, it takes dying loved ones begging their family members to get vaccinated. Some people are starting to listen," Miller said.
(New York) — Boosted by a recent uptake in vaccine administrations, the U.S. crossed a long-awaited milestone Monday in its race to vaccinate the country against the novel coronavirus.
Seventy percent of U.S. adults ages 18 and older have received at least one vaccine dose, Cyrus Shahpar, the White House's COVID-19 data director, posted in a tweet.
This is nearly a month after the country missed President Joe Biden's July 4 deadline to meet that threshold.
Although the majority of the country’s adults have one shot, there is a major discrepancy among states, according to the CDC.
Health officials have been urging eligible residents to get their shots, which are free and shown to prevent hospitalization and death from the virus, as soon as possible as the more contagious variants like delta spread.
As of Monday, 22 states and the District of Columbia have 70% of their adult population with one dose, according to data from the Centers for Disease Control and Prevention. Many of these states are located in the Northeast with Vermont leading the nation with over 86% of its adult residents receiving one shot, according to the health data.
A dozen states, almost all located in the South, haven’t cracked the 60% mark for their adult residents with one shot, CDC data showed. Mississippi has the lowest percentage of adults with one shot, at 50%, according to the data.
Coronavirus cases and hospitalizations in the country have been on the rise, particularly in locations with low vaccination numbers, health officials said.
Officials in several states, including Mississippi, Alabama, Missouri and Arkansas, are reporting that the majority of their hospitalized patients are unvaccinated people.
The U.S. began vaccinating residents in December, starting with health care workers and the elderly. By mid-April, all residents above 18 were eligible and a month later, the Pfizer vaccine was approved for Americans over the age of 12.
Two of the three approved vaccines, Pfizer and Moderna, require two doses and use mRNA technology to protect against the virus. The Johnson & Johnson vaccine requires only one dose.
The seven-day average of new daily first shots administered peaked at 3.4 million on April 11 but it has declined to low of 217,884 on July 7, the CDC reported. Several states that had lagging vaccination numbers, however, saw a small jump in shots administered during the final weeks of July.
The seven-day average of first doses administered grew to 367,351 on July 27, the CDC data showed.
On Sunday, White House COVID-19 data director Cyrus Shahpar revealed that over 517,000 people received their first shot.
Anyone who needs help scheduling a free vaccine appointment can log onto vaccines.gov.
Some of those heading up Black-led health nonprofits and organizations told ABC News of the constant battle for them as smaller, minority-focused health care nonprofits to get government funding and attention from potential corporate sponsors who typically focus on mammoth nonprofits like Susan G. Komen and the American Cancer Society.
Several studies and data show that systemic racism permeates the health care nonprofit and research world and some say that could stymie lifesaving medical solutions and impede the on-the-ground work nonprofits do for health and wellness in underrepresented communities.
Bias in funding "absolutely" has the potential to keep lifesaving medical solutions from emerging, said Dr. Tshaka Cunningham, a former Department of Veterans Affairs scientific program manager who was instrumental in securing Green's $1.1 million grant, and sits on the board of her foundation.
"In the whole scientific enterprise it's difficult to achieve funding and historically found to be biased against people of color. Sometimes when you have data that is really good, the status quo doesn't believe you," said Cunningham, a molecular biologist and co-founder of TruGenomix Inc., a biotechnology company.
He said bias also exists in the entire nonprofit grant process as well as with mentorship, which can help form strategic connections to secure funding.
Green's predicament is shared by other Black scientists and researchers, who are often met with closed wallets, whether they launch a nonprofit or a for-profit startup. Brian Brackeen, founder of Lightship Capital, a venture capital fund serving underrepresented entrepreneurs, and an expert in funding Black startups, discussed the funding woes of yet another Black woman with a health care innovation.
Brackeen said Davielle Jackson, a health care entrepreneur, could not secure funding for her invention, highly absorbent menstrual panties. He said his firm led her first round of funding and that she is now making revenue as a successful business.
But, Brackeen said: "The question is why wasn't she invested in before?"
He said the funding situation is similar with Black entrepreneurs as with Black-led nonprofits, "[With] women or minority founders, they're simply told [by potential investors] 'you don't fit this exact box, and I'm not going to help you fit it,'" Brackeen said.
Black health care nonprofits are typically entrenched in the communities they serve. They are usually staffed with people from those communities who have long-established relationships with residents. They can often make in-roads into providing health and wellness services in those communities that outside organizations cannot. When these nonprofits are underfunded and strapped for cash, those communities can lack access to vital health care and information.
Green's struggles mirror other Black-led health organizations
Green set out on a mission to use her Ph.D. in physics from Alabama A&M University, as well as her research with optics and laser technology, to defeat the disease that remains the second-leading cause of death in the U.S. She used the $1.1 million grant to carry out initial research at the Morehouse School of Medicine.
Green describes her research as "laser-activated nanotechnology."
"It has already demonstrated complete elimination of human cancer in laboratory mice after one 10-minute treatment over the course of 16 days with no observable side effects; no chemo, no radiation, no surgery. It is a game-changer for solid tumors," she said.
Despite these promising early results, she has not been able to attract corporate or government interest in her research.
Green's stymied efforts track with long-standing disparities in the research funding system.
In a 2011 study published in the peer-reviewed journal Science, researchers found that Black applicants are 13% less likely to receive National Institutes of Health research funding compared to white applicants. The study concluded that factors including "perception of scientific merit," lack of diversity among grant reviewers and where an applicant attended school can influence who receives grants, all of which can place underrepresented groups at a disadvantage.
The NIH set out to make the grant process more equitable in 2014 including appointing its first chief officer of scientific workforce diversity and establishing the NIH Scientific Workforce Diversity Office.
As of 2020, the funding gap has narrowed, but African American/Black applicants are still 7% less likely to receive R01 (or equivalent) grants than white applicants, according to the latest data from NIH. R01 grants are described by NIH as "mature research projects that are hypothesis-driven with strong preliminary data.”
The landmark analysis quantified what many Black scientists already suspected, and sparked calls for policy intervention to address the funding gap. A follow-up study published in the journal Science Advances in 2019 said the funding rate for white scientists remained 1.7 times higher than for Black scientists. The researchers of this study suggested the funding gulf was due to topic choice, saying Black scientists "tend to propose research on topics with lower award rates."
The flip side: Elizabeth Holmes' Theranos jackpot
The funding obstacles of Black people with health care initiatives stand in stark contrast to the now-infamous Elizabeth Holmes, a young, white woman. Holmes claimed she had developed a revolutionary blood-testing solution that could detect diseases including cancer.
The college dropout had no peer-reviewed publications, advanced degrees or any academic background in cancer research, yet her appeals for funding her health care startup Theranos raked in hundreds of millions from investors, and made her Forbes' "youngest self-made woman billionaire" in 2015.
She has since faced a litany of fraud charges, to which she and a former partner in the company have pleaded not guilty, and her trial, delayed by the COVID-19 pandemic, remains ongoing.
Holmes received money from private investors largely through her family's connections. But her access and influence skyrocketed so that even drugstore chain titan Walgreens considered a partnership with Theranos, although the technology had not been vetted, according to a report from the Wall Street Journal.
The disparity between Holmes' ease in gaining investor and corporate trust versus her own experience has caused frustration for Green and other Black health care nonprofit leaders and researchers, who have faced closed door after closed door.
It's the "the essence of white privilege," Cunningham said about Holmes' ability to secure millions for Theranos.
"Who you know" is also a big part of getting dollars for a private company or a nonprofit foundation like Green's.
Green's research is in the fledgling stage, however, which could also explain her obstacles in raising funding, medical experts who ABC News asked to review a peer-reviewed report of Green's research told ABC News, as well as the fierce competition to fund such initiatives.
"The funding landscape is so competitive even for super-compelling research that could save the lives of many," said Dr. John Brownstein, a Harvard epidemiologist and ABC News contributor.
It's "a struggle," C. Virginia Fields, the founder and CEO of Black Health told ABC News about securing funds for Black-led heath care nonprofits.
"We've been able to tap into some of the local funding … COVID funding, but the funding streams for programs, certainly outside of just COVID have basically been brought to a standstill," said Fields, a former Manhattan borough president and a 2005 New York City mayoral candidate.
Fields said nonprofits such as hers, are often offered things like computers in lieu of money. "We don't need computers," she said. "If you got $3 million on this contract let's talk about some funding so that we can increase staff with people on the ground," she said.
(NEW YORK) — As COVID-19 surges nationwide, the seriousness of the virus's latest wave is reflected in newspaper headlines from cities and states across the country.
The number of new COVID-19 cases is reaching levels previously seen in February, as the U.S. was emerging from the winter surge.
The U.S. reported over 100,000 new daily COVID-19 cases for the first time since Feb. 6 on Friday, according to the Centers for Disease Control and Prevention.
This latest surge is fueled by the highly contagious delta variant. A new internal CDC report first published by The Washington Post and confirmed by ABC News, said the variant could be more contagious than Ebola, Spanish flu, chickenpox and the common cold. It's also possible delta leads to more severe illness, though that is not confirmed.
Based on its latest findings on the transmissibility of the delta variant, the CDC revised its mask guidance earlier this week, now recommending that those in areas with substantial or high levels of transmission -- vaccinated or not -- wear a mask in public, indoor settings.
A sampling of headlines from newspapers across the country Saturday spotlight areas experiencing spikes in cases and overwhelmed hospitals, and how they're responding.
"Florida is the epicenter," read the Tampa Bay Times, reporting that the state had the most cases and hospitalizations in the U.S. in the past week. On Saturday, Florida reported its largest single-day increase in cases since pandemic began.
The Honolulu Star Advertiser reported on a spike in cases in Hawaii that accounted for the highest daily case count since the start of the pandemic.
In Louisiana, another hotspot, The Advocate reported that the state's hospitals are "overwhelmed again," as it experiences its fourth wave of the virus.
Mississippi is also experiencing overwhelmed hospitals. "State’s largest ICU full," the Clarion-Ledger reported, referring to the intensive care unit at the University of Mississippi Medical Center in Jackson.
Hospitalizations are climbing at the East Alabama Medical Center, increasing from eight at the start of the month to 34 as of Friday, the Opelika-Auburn News reported.
The Houston Chronicle detailed how Texas surpassed New York in COVID-19 deaths to have the second-highest death toll in the nation, "a feat experts say was driven by an inability to control transmission of the virus here," the paper reported.
As cases quickly rise, restrictions are returning in some regions. The Times-Picayune in New Orleans reported on the city reissuing an indoor mask mandate due to its surge, with the headline. "Mask mandate back in N.O." -- one of several cities and counties to do so in recent days.
"Mask recommendations rise across Maine," the Kennebec Journal in Augusta reported.
"State emphasizes need for shots," read Saturday's headline in The Journal Gazette in Fort Wayne, Indiana, as health officials urged residents to get vaccinated and bolster the state's relatively low vaccination rate.
"This means that given all the impact the pandemic had on our way of life and on emissions, it couldn't undo these deeply rooted disparities," said Dr. Gaige Kerr, lead author of the study and a scientist in the Department of Environmental and Occupational Health at George Washington University.
Overall, the pandemic took an uneven toll on minority communities, especially African Americans who had twice the risk of COVID-19 at the height of the pandemic, compared to white populations.
Although pollution levels decreased throughout urban areas during the pandemic, nitrogen dioxide levels were still elevated in primarily minority neighborhoods. The same finding held true when comparing income and educational attainment, though, it was not as significant as race and ethnicity.
"Exposure to air pollution has been linked to a number of health problems including asthma, heart disease, preterm birth and mortality," said Dr. Stephanie Lovinsky-Desir, director of the Pediatric Pulmonary Division at Columbia University Irving Medical Center, as well as a volunteer medical spokesperson for the American Lung Association. Lovinsky-Desir was not a part of the research team.
The new pollution study analyzed various demographics of 15 urban cities throughout the United States including Los Angeles, Atlanta, Detroit and New York City.
Researchers analyzed levels of nitrogen dioxide, an air pollutant related to traffic and associated with health impacts, such as asthma and chronic obstructive pulmonary disease. For children and the elderly exposed to these emissions, their risk of developing these conditions increases.
"Neighborhoods near highways and dense urban corridors are the areas at the greatest risk of high levels of exposure and adverse health effects," said Dr. Renee Crichlow, chief medical officer, Codman Square Health Center and vice-chair of health equity at Boston University Medical School.
And nitrogen dioxide has a "direct impact on the lungs," said Crichlow, potentially causing "irritation and inflammation of the lining of the respiratory system."
It's not surprising minority communities are clustered in higher-pollution areas, Kerr says.
"When we look at the history of the U.S. in the 20th century going all the way back to the days of red-lining, a lot of the ways that our urban areas were constructed, where highway interstates are, which neighborhoods are located by certain industries, that is years and years of racism that's again woven into the fabric of cities," he said.
"It's going to take a lot of policy efforts to rethink the way that our emissions are distributed throughout the city equally and try to undo years and decades’ worth of environmental injustices."
Researchers are hoping for broader policies to help curb pollution disparities. But in the meantime, there are small things everyone can do to aid this nationwide issue.
Kerr suggests rerouting heavy-duty trucks out of certain city neighborhoods. Also: "Driving less, support greener public transportation options, such as electric buses and rails, and have tighter emissions control on both personal vehicles and industrial processes," are other suggestions Crichlow proposed.
"Together we can actually make a difference in the health of our children and communities," Crichlow said.
Alexis E. Carrington, M.D. is an ABC News Medical Unit Associate Producer and a rising dermatology resident at George Washington University.
(NEW YORK) -- In a society where women face all kinds of disparities, there is one gap that women may not know about, even though it can lead to shame, guilt and unanswered questions.
That is the "orgasm gap," a term coined by health experts based on data that shows that, in heterosexual relationships, women on average are having fewer orgasms than men, by as much as 95% for men compared to 65% for women, according to one study.
Lesbian women also have significantly more orgasms, while for men, the orgasm rate doesn't vary much with sexual orientation, the data shows.
"There's a huge discrepancy and part of the reason is lack of knowledge," said Dr. Nita Landry, a Los Angeles-based OBGYN. "We just have to talk about it or, otherwise, we're just going to keep having the sex life that we have overall as women, and that gap is going to continue to be there and nothing is going to change."
An orgasm, considered the peak of sexual pleasure, is a physical reflex that happens when muscles tighten during sexual arousal.
The miseducation around women and orgasms goes back centuries, according to Katharine Smyth, a Brooklyn-based author whose own self-doubt about not being able to orgasm led her to research the topic for an article titled "The Tyranny of the Female Orgasm-Industrial Complex."
"Going back as far as Aristotle, who believed that only women with fair skin and fair hair could have orgasms, it's been shrouded in just a series of misconceptions, one after the other," said Smyth. "And another thing I realized when I was doing the research is that a lot of women just don't ... know that much about their bodies."
The historically male-dominated medical field hasn't helped women completely either, as researchers and doctors have not solved the puzzle of what prevents orgasm in women, and how to treat it medically.
"I think it all started a long time when someone just laid down this narrative about what sex was supposed to look like, and when they spelled out the narrative ... they really focused on men," said Landry. "They looked at what a sexual encounter looked like for a typical man and what brought that man pleasure and then they just said, 'Oh, by the way, this is going to work for women too.'"
"The problem is, that's not how it works," she said.
Here are five myths about female orgasms explained and corrected by Landry and Smyth.
Myth #1: Women need to orgasm to have pleasurable sex.
When Smyth got divorced at age 34 and started dating again, she says she encountered a series of men who did not believe she was enjoying sex without orgasming.
"Some actually broke up with me, because I couldn't have an orgasm," she said. "The thing that was really frustrating for me was that they kept saying, 'You're not enjoying sex enough?' and I would say, 'No, I'm really enjoying sex. I'm having a great time.'"
"That was just such a frustrating feeling to kind of be told that I wasn't enjoying myself enough," recalled Smyth.
An orgasm is something that happens to some women, but not all, and is not the only sign of a successful sexual experience, according to Landry.
"You definitely can have sex that is super enjoyable without having an orgasm," she said. "When a woman is OK with not having an orgasm, when a woman is enjoying the emotional connection, or the non-orgasmic pleasure associated with having sex, then that's 100% okay."
Don't make the orgasm, the goal, make pleasure the goal
Landry explained, "A big part of it is making pleasure your goal. Don't make the orgasm, the goal, make pleasure the goal."
Myth #2: Women can only orgasm through penetrative sex.
While popular culture tells us otherwise, for women, having an orgasm through penetrative sex, or intercourse, is much less of a guarantee than it is for men.
A long held piece of data, published in Elisabeth A. Lloyd's 2006 book, "The Case of the Female Orgasm," found that around 75% of all women never reach orgasm from intercourse alone.
More recent data, published in The Journal of Sex and Marital Therapy in 2017, found that just 18% of women in the United States orgasmed through intercourse alone. Nearly 40% of women meanwhile required clitoral stimulation to experience orgasm.
The clitoris is the pleasure center of the vulva, the outer part of female genitals. In many cases, due to women's anatomy, the clitoris does not get adequate stimulation with penetration, according to Landry.
"When patients come to see me, a lot of times some of them actually come in disappointed that they're not able to have an orgasm from just penetration.," she said. "And then I'll say, 'Okay, well, can you have an orgasm with clitoral stimulation?, 'and they're like, 'Oh, yeah, well, that's fine,' but that's not the orgasm that they want."
"It's a matter of just educating them and just making sure that they understand they are not broken, they are not abnormal," continued Landry. "It's just that they've been taught that that's what sex is supposed to look like for everybody, when that's not the case."
Myth #3: Women have to just fake it until they make it.
Meg Ryan's famous orgasm scene in "When Harry Met Sally" may have put faking an orgasm in the spotlight forever, but women don't need to fake it.
While there is not yet a pill or prescription for the female orgasm, there are things that can be done to help, if that is what a woman wants, according to Landry.
"Based on the research that we do have, your best treatment options are going to be centered on therapy," she said, noting a specific option called cognitive behavioral sex therapy. "A lot of times [therapists] will start with education and educating women about their bodies, and helping women to figure out what they like ... and they'll also talk about behavioral stuff and relationship stuff."
Women can also do things on their own, like exploring their own bodies to know their pleasure points and practicing mindfulness outside the bedroom.
"You can start by doing simple things like when you are eating, just being in that moment, and paying attention to how the food feels in your mouth and how that tastes," said Landry, adding that if your mind wanders, practice bringing it back to the moment. "It's a skill that you learn, and then you take that into the bedroom."
Landry also recommends that women look at what could be putting the brakes on their sex life, which can include everything from certain medications and medical issues like endometriosis to body issues, relationship conflicts, stress and a history of abuse or trauma.
"You want to address anything that you can address, anything that is going to 'press on the brake,'" she said.
Misconception #4: It's up to a man to decide how a woman is pleasured:
"It's not the fact that you don't have an orgasm. It's how you feel about the fact that you're not having an orgasm," said Landry. "And if you are OK with pleasure, if that's good enough for you, that should be good enough for [your partner]."
Communication is lubrication.
Landry uses the phrase "communication is lubrication" with her patients to let them know they need to express their sexual desires and pleasures with their partners.
"When it comes to female pleasure, it is very important for you to know what you like so that you can communicate that to your partner," she said. "Sometimes what happens is men will come into a relationship knowing what worked for their other partner or partners, and they'll try those same things that might not work for you."
"So when you get in a situation where you're not willing to communicate, or you fake an orgasm, he thinks that he's doing something that you really like and that goes to that becomes his go to signature move," Landry continued. "Then you're in a situation where you're not able to enjoy your sexuality the way that you should be able to."
Myth #5: Women who don't have orgasms are broken.
Smyth's article on female orgasms prompted the biggest response she said she has received on any article she's ever written.
"The majority were women who were saying, 'Thank you so much for writing this. I thought there was something wrong with me, I thought I was broken,'" said Smyth. "There were a lot of people whose partners had broken up with them because of it, or had made them sort of feel inadequate because of it."
Not only are women who either don't orgasm or don't worry about orgasming not broken, they're perfectly normal and actually in the majority, according to the data.
"I've now been with a man for a year and he couldn't be more generous, couldn't be more accepting," said Smyth. "So one thing I would say to women in my position is that there are definitely men out there who do possess the necessary generosity, the necessary maturity."
"And if you're feeling frustrated about your orgasm, try and fix that for you, not for a man," she said.
GoodMorningAmerica.com is tackling a different taboo women's health topic each month, breaking down stigmas on everything from mental health to infertility, STDs, orgasms and alcoholism.
(NEW YORK) -- Anyone hoping to catch a Broadway show as the Great White Way reopens this fall will need proof of vaccination along with their ticket.
The Broadway League announced Friday that theater owners and operators of all 41 New York City theaters will require all theater attendees to be vaccinated against COVID-19 for all performances through October 2021. Additionally, this also applies to all performers, backstage crew and theater staff.
Masks will also be required for audience members while inside the theater "except while eating or drinking in designated locations."
Theatergoers will need to be fully vaccinated with an Food and Drug Administration or World Health Organization-approved vaccine and must show proof of vaccination at their time of entry with a valid ticket. For those who took Pfizer or Moderna vaccine, the performance they attend must fall at least 14 days after their second dose. For those who opt for Johnson & Johnson, the show they attend must be 14 days after their single dose.
The Broadway League also said that ticket holders for performances through Oct. 31 will be notified of the new rules and be kept abreast of an anticipated review of the policies in September. The organization said the future review "may include a relaxation of certain provisions if the science dictates."
Charlotte St. Martin, the president of the Broadway League, said "a uniform policy across all New York City Broadway theatres makes it simple for our audiences and should give even more confidence to our guests about how seriously Broadway is taking audience safety."
Exceptions will be made for children under 12 and those with medical conditions or religious reasons for not getting vaccinated. These individuals must instead provide proof of a negative COVID-19 PCR test taken within 72 hours of a show's start time or a negative COVID-19 antigen test taken within 6 hours of the start time.
This news comes amid rising concerns over the delta variant of COVID-19.
(NEW YORK) -- The nation's two leading health organizations focused on the care of pregnant people have issued new guidelines calling on all pregnant people to get vaccinated against COVID-19.
The new joint recommendation from the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) comes as the United States faces both a low vaccination rate and a summer surge of COVID-19 cases as the more contagious delta variant spreads.
Just 16% of pregnant people in the U.S. had received more than one dose of a COVID-19 vaccine as of May, compared to the nearly 58% of Americans ages 12 and up who are fully vaccinated against COVID-19, according to data from the Centers for Disease Control and Prevention (CDC).
"ACOG is recommending vaccination of pregnant individuals because we have evidence of the safe and effective use of the vaccine during pregnancy from many tens of thousands of reporting individuals, because we know that COVID-19 infection puts pregnant people at increased risk of severe complications, and because it is clear from the current vaccination rates that people need to feel confident in the safety and protective value of the COVID-19 vaccines,” ACOG president Dr. J. Martin Tucker said in a statement. “Pregnant individuals should feel confident that choosing COVID-19 vaccination not only protects them but also protects their families and communities.”
Both ACOG, a national membership organization for more than 60,000 OBGYNs, and SMFM, a global organization with more than more than 5,000 physicians, scientists and women's health professionals, previously recommended that pregnant people have access to vaccines and should "engage in shared decision-making" about the vaccine with their doctors.
“COVID-19 vaccination is the best method to reduce maternal and fetal complications of COVID-19 infection among pregnant people,” Dr. William Grobman, president of SMFM, said in a statement announcing the new recommendation, also noting the vaccines are safe before, during and after pregnancy.
Here is what pregnant and breastfeeding people may want to know about the COVID-19 vaccines to help them make informed decisions.
1. When can pregnant people get a COVID-19 vaccine?
Everyone 12 years of age and older, including pregnant people, is now eligible to get a COVID-19 vaccination, according to the U.S. Centers for Disease Control and Prevention (CDC).
Pregnant people can get the COVID-19 vaccine at any point in their pregnancy, and the vaccine does not need to be spaced from other vaccines, like the flu shot or Tdap booster.
2. What is the science behind the COVID-19 vaccine?
Both the Pfizer and Moderna vaccines use mRNA technology, which does not enter the nucleus of the cells and doesn’t alter the human DNA. Instead, it sends a genetic instruction manual that prompts cells to create proteins that look like the virus a way for the body to learn and develop defenses against future infection.
They are the first mRNA vaccines, which are theoretically safe during pregnancy, because they do not contain a live virus.
The Johnson & Johnson vaccine uses an inactivated adenovirus vector, Ad26, that cannot replicate. The Ad26 vector carries a piece of DNA with instructions to make the SARS-CoV-2 spike protein that triggers an immune response.
This same type of vaccine has been authorized for Ebola, and has been studied extensively for other illnesses -- and for how it affects women who are pregnant or breastfeeding.
The CDC has concluded that pregnant people can receive the Johnson & Johnson one-shot vaccine after reviewing more than 200 pages of data provided by the company and the U.S. Food and Drug Administration (FDA).
Vaccine experts interviewed by ABC News said although pregnant women are advised against getting live-attenuated virus vaccines, such as the one for measles, mumps and rubella, because they can pose a theoretical risk of infection to the fetus, the Johnson & Johnson vaccine doesn't contain live virus and should be safe.
3. Are there studies on pregnant women and the COVID-19 vaccine?
Two recent studies found Pfizer and Moderna's COVID-19 vaccines appear to be "completely safe" and effective for pregnant people, according to Dr. Francis Collins, director of the National Institutes of Health (NIH).
Collins wrote in a blog post that the Pfizer and Moderna vaccines, which both use mRNA technology, were found to provide in pregnant people the levels of antibodies and immune cells needed to protect them against COVID-19.
The vaccines were also found to likely offer protection as well to infants born to a vaccinated person, according to Collins.
"Overall, both studies show that COVID-19 mRNA vaccines are safe and effective in pregnancy, with the potential to benefit both mother and baby," he wrote, later adding, "While pregnant women are urged to consult with their obstetrician about vaccination, growing evidence suggests that the best way for women during pregnancy or while breastfeeding to protect themselves and their families against COVID-19 is to roll up their sleeves and get either one of the mRNA vaccines now authorized for emergency use."
One study cited by Collins in his blog post was led by researchers at Northwestern University studying people who had been fully vaccinated during pregnancy.
The study, published May 11 in the journal Obstetrics & Gynecology, is believed to be the first to examine the impact of the COVID-19 vaccines on the placenta, according to the university. Researchers found the vaccine had no impact on pregnancy and no impact on fertility, menstruation and puberty.
The second study cited by Collins, led by researchers at Beth Israel Deaconess Medical Center and Harvard Medical School, looked at more than 100 women who chose to get either the Pfizer or Moderna vaccines. Researchers found that the women's antibodies against COVID-19 after being fully vaccinated were also present in infant cord blood and breast milk, "suggesting that they were passed on to afford some protection to infants early in life," according to Collins.
An earlier study, a study published in the American Journal of Obstetrics & Gynecology in March found the Pfizer and Moderna vaccines are safe and effective in pregnant and lactating people and those people are able to pass protective antibodies to their newborns.
Researchers studied a group of 131 reproductive-age women who received the Pfizer or Moderna vaccine, including 84 pregnant, 31 lactating and 16 non-pregnant women and found antibody levels were similar in all three groups. No significant difference in vaccine side effects were found between pregnant and non-pregnant study participants.
The study had some limitations. It was small and participants were primarily white health care workers from a single city. On the other hand, it's the largest study of a group that was left out of initial vaccine trials.
4. What are health groups saying about the COVID-19 vaccine?
In addition to ACOG and SMFM, other health organizations have also said COVID-19 vaccines are safe for pregnant people.
The World Health Organization (WHO) says pregnant people at high risk of exposure to COVID-19 and those at risk of severe disease should be vaccinated.
"While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy," WHO said in a statement. "Nevertheless, based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women. For this reason, those pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease, may be vaccinated in consultation with their health care provider."
The CDC says people who are pregnant and breastfeeding "may choose to be vaccinated" and should talk with their health care provider, noting that breastfeeding is an important consideration but "is rarely a safety concern with vaccines."
"Getting a COVID-19 vaccine during pregnancy can protect you from severe illness from COVID-19," the CDC states on its website. "If you have questions about getting vaccinated, a conversation with your healthcare provider might help, but is not required for vaccination."
5. What will clinical trials be like for pregnant people?
Pfizer's phase 2/3 trial will enroll approximately 4,000 women within weeks 24-34 of their pregnancy, the company announced in a press release.
Half will get the vaccine, and half will get a placebo.
The study will include healthy, pregnant woman age 18 and older in the U.S., Canada, Argentina, Brazil, Chile, Mozambique, South Africa, the United Kingdom and Spain.
Participants in the vaccine group will receive two doses at 21 days apart -- and each woman will be followed for at least 7-10 months in order to continuously assess for safety in both participants and their infants.
Infants will also be assessed, up until 6 months of age, for transfer of protective antibodies from their vaccinated mother.
Women enrolled in the trial will be made aware of their vaccine status shortly after giving birth to allow those women who originally received placebo to be vaccinated while staying in the study.
6. Why weren't pregnant people included in early clinical trials?
Not recruiting parents-to-be in clinical trials and medical research is nothing new, according to Dr. Ruth Faden, the founder of the Johns Hopkins Berman Institute of Bioethics and a bioethicist who studies the ethics of pregnancy and vaccines.
"For a very long time, pregnant women were not included in biomedical research evaluation efforts or clinical trials, both for concerns about fetal development and what would be the implications of giving a pregnant women an experimental drug or vaccine and also for legal liability worries from manufacturers and pharmaceutical companies," Faden told "GMA" last month. "There’s a huge gap between what we know about the safety and effectiveness of a new drug or a new vaccine for the rest of the population and what we know about it specific to pregnancy."
In the case of the COVID-19 vaccines, health experts have only one of the three sources of evidence that are used to evaluate safety and efficacy during pregnancy: the data on non-pregnant people who were enrolled in the clinical trials, according to Faden.
From that, Faden said, health experts can try to glean what side effects may happen to people who are pregnant, but it is not an exact science.
However, it's considered typical -- and many argue ethically appropriate -- to study an unknown substance first in healthy adults and then progressively in broader and broader populations. Pregnant people and children are often tested later down the line because of concerns about potential long-term harm.
Some of the volunteers in prior COVID-19 vaccine trials that didn’t include pregnant women directly may still become pregnant during the trial. This will also give researchers some insights about the vaccine's safety among this group.
7. What risk factors should pregnant people consider?
At this time, the CDC recommends that pregnant women be prioritized for vaccinations and encourages them to speak to their doctors about the risks and benefits of a vaccination.
The question of whether an expecting parent should receive a COVID-19 vaccine will eventually come down to a number of factors, including everything from the trimester, risk factors for COVID-19, ability to remain socially distanced in their lifestyle and occupation, guidance from federal and state officials and recommendations from a person's own physicians, experts say.
Similar to the flu vaccine, which was not tested on pregnant people in clinical trials, health experts will need to rely on continuously incoming data to make decisions around how safe the COVID-19 vaccines are during pregnancy.
Officials are doing the same for the general population, considering the speed at which the COVID-19 vaccines were developed, according to Faden, who noted that people who are pregnant should not be "unnecessarily alarmed."
The COVID-19 vaccines can be taken during any trimester. Since other vaccines are recommended during pregnancy, the CDC currently recommends spacing out vaccine appointments a few weeks apart, if possible.
8. Is COVID-19 more dangerous for pregnant people?
Even now, more than one year into the coronavirus pandemic in the U.S., some questions remain about how pregnant people are impacted by COVID-19.
The CDC has shared data showing that pregnant people infected with COVID-19 are at an increased risk for "intensive care unit admission, invasive ventilation, extracorporeal membrane oxygenation, and death," compared to nonpregnant people.
Health experts say that with or without the vaccine, pregnant people need to continue to remain on high alert when it comes to COVID-19 by following safety protocols, including face mask wearing, social distancing and hand washing.
ABC News' Sony Salzman and Eric Strauss contributed to this report.
(TAMPA, Fla.) -- A jarring reality check is taking place in intensive care units across the country as thousands of COVID-19 positive patients, nearly all of them unvaccinated, are streaming into hospitals in need of care.
This is particularly true in Florida, where virus-related hospitalizations have skyrocketed in recent weeks. The situation has escalated rapidly, now nearing peak levels, with nearly 7,900 patients hospitalized with the virus across the state, up by more than 320% in the last month, according to data from the Centers for Disease Control and Prevention.
"It feels like it's an impending storm ... there's no off ramp to this getting worse," Dr. David Wein, an emergency room physician at Tampa General Hospital in Florida, told ABC News on Wednesday.
On Tuesday this week, more than 1,450 patients with COVID-19 were admitted to hospitals across the state, marking the highest number of patients seeking care within a 24-hour period in Florida since the onset of the pandemic.
"Right now, at Tampa General Hospital, we are really feeling the crush of this increase incidence of COVID-19, and so the delta area has really brought many patients to our emergency room, requiring treatment and admission," Peggy Dugan, the executive vice president and chief medical officer at the hospital, told ABC News in an exclusive interview.
It was just six weeks ago that some of the team thought they may be out of the woods, with metrics steadily trending down across the country.
"It felt like we were ready to move in the right direction and start seeing it plateau. And it was a surprise to see it trend up like it did," said Erika Mergl, nurse manager for the Tampa General Hospital's Global Emerging Diseases Institute.
However, virus-related hospitalization levels are now nearing peak levels.
"We're getting to numbers that were as high as last summer. In early July, we were down to 12 COVID-19 patients in the hospital, and today we have 80. So we're really just seeing an escalation over a short span of time," Duggan said.
The situation in Tampa is not an anomaly. Nearly every state in the country is now experiencing case, and COVID-19 hospitalization increases. Virus-related hospitalizations levels are now at their highest point since April, with nearly 33,700 patients receiving care -- about 10,000 more patients than a week ago.
Many of the patients at Tampa General are younger, Dugan said, some as young as 22 or 23 years old, and "almost" all of them have been unvaccinated, the hospital said.
One of the hospital's unvaccinated patients is 64-year-old patient Gerard Considine, who spent nine days intubated after he tested positive for the virus.
"I'm not used to being scared of anything, but this scared the hell out of me," Considine told ABC News.
Considine said he didn't get the COVID-19 vaccine because he had experienced adverse reactions to other vaccines, but despite his ordeal, he does not think he will choose to be vaccinated, believing that he has developed some antibodies, at this point.
However, said Duggan, "we're seeing people who are recovering now very regretful that they didn't get the vaccination in the first place."
Many of the patients coming to the hospital are already quite ill when they arrive, said Wein.
"Unfortunately, we're seeing people who are coming in days, or several days, into their disease and sicker, with difficulty breathing, needing to be admitted to the hospital. So it feels more like that winter surge that we had," Wein said, adding that a number of these patients end up on ventilators.
"This is heartbreaking because all this could have been avoided, this is unnecessary human suffering that we are witnessing right now," Dr. Seetha Lakshmi, the medical director of the Global Emerging Diseases Institute at Tampa General Hospital, told ABC News.
Several front-line workers at Tampa General Hospital expressed to ABC News their deep concern and fear about the next several weeks for their teams, given the state's and the hospital's exponential increase in infections and virus-related hospitalizations, stressing that their message to Americans is that vaccinations are key to controlling the pandemic and ending the suffering.
The difference in getting vaccinated, or not getting vaccinated is ultimately akin to "the difference between having a cold and dying," said Wein. "If a vaccinated patient gets this, they're most likely going to be just fine, and not going to end up in the hospital. Unfortunately, the unvaccinated person has a really high likelihood that he will end up hospitalized on a ventilator."
(NEW YORK) -- A flurry of new scientific findings is prompting renewed concern among doctors about the long-term cognitive impacts of COVID-19 in some patients.
Several new studies presented at the Alzheimer's Association International Conference, being held this week in Denver, have found that many COVID-19 patients experience "brain fog" and other cognitive impairments months after recovery. This adds to a growing body of research on COVID-19's apparent long-haul symptoms, which can include confusion, forgetfulness and other worrying signs of memory loss.
"This research features the first data from an international consortium, which includes the Alzheimer's Association, investigating the long-term consequences of COVID-19 on the brain," Heather Snyder, the vice president of medical and scientific relations for the Alzheimer's Association said in prepared remarks.
Not enough time has passed for researchers to know if these worrying symptoms eventually clear up. However, they're pointing to these studies as renewed evidence that everyone -- especially older people who are already vulnerable to cognitive decline -- should get vaccinated.
"While we work together to further understand the lasting impacts of COVID-19 on the brain, the take home message is simple: don't get COVID-19. And the best way to do that is by getting vaccinated," Maria Carrillo, chief science officer for the Alzheimer's Association, said in prepared remarks.
Researchers at the University of Texas Health Science Center studied the cognition and olfactory senses of 300 older adult Amerindians from Argentina who contracted COVID and found that 50% had persistent problems with forgetfulness and 25% had additional problems with language and executive dysfunction.
"A large portion of our patients in the COVID Recovery Program exhibit cognitive signs and symptoms long after the inflammatory phase of COVID has passed. We typically see many patients with naso-pharyngeal predominant illness come back to us with more neurocognitive deficits," Dr. Thomas Gut, director of the Post-COVID Recovery Center at Staten Island University Hospital, told ABC News. Gut was not involved in any of the studies presented at the conference.
Researchers at the New York University Grossman School of Medicine studied blood samples of 310 patients admitted to NYU Langone Health with COVID for the presence of biomarkers that would indicate brain inflammation and damage. High levels of certain biomarkers were strongly associated with inflammation in the brain. Damage to the blood-brain barrier caused by inflammation can result in the brain's inability to send messages from the brain to other parts of the body.
"So far, our efforts offering supportive therapies have shown improvement, but the recovery time is still measured in months. Finding a cause and mechanism for these inflammatory changes in the brain would be the first place to start in addressing how to reverse or prevent these inflammatory changes," said Gut.
Researchers from the University of Thessaly reviewed the cognitive function and overall health of 32 patients with mild to moderate COVID infection two months post-hospitalization and found that more than 50% experienced cognitive decline, particularly with short-term memory. They also found that poorer memory and thinking scores were associated with lower level of oxygen saturation during a short walk test.
"Many of the cognitive changes that we see mirror in many ways Alzheimer's disease or PTSD," said Gut. "What is becoming clearer, is that the severity of acute infection does not directly predict neurocognitive changes after the acute phase has passed. We have many patients that had mild infection or illness struggle severely with memory or behavior changes."
(NEW YORK) -- As COVID-19 cases surge across much of the United States and many vaccinated people return to indoor masking, a pattern appears to be emerging -- the same states that are seeing the biggest increases in COVID-19 infections also have high rates of residents who don't have health insurance.
"It lines up with everything we've seen during the pandemic," said John Brownstein, Ph.D., the chief innovation officer at Boston Children's Hospital and an ABC News contributor. "Uninsured communities have less access to testing, less access to vaccines and less access to care. So of course, you're going to have increased overall risk among those populations," he added.
"It's playing out as we would have anticipated in a pandemic."
Florida, where Gov. Ron DeSantis has mocked the use of masks and issued an executive order to block government entities from requiring COVID-19 vaccines, has emerged as a cautionary tale. Along with Louisiana, Florida now has the country's highest COVID-19 case rate, with more than 400 new cases per 100,000 residents as of Wednesday, according to CDC data.
"Florida is in the worst spot right now," said David Radley, a senior scientist for The Commonwealth Fund, a New York City-based foundation that promotes better access to quality health care. "It has the highest emerging case rate and it has a high level of uninsured."
Florida might hold the dubious distinction of having among the highest new COVID-19 case rates coupled with a 19% uninsurance rate, but a number of other states are struggling with increasing COVID burdens and a health system that's not set up to easily handle -- or pay for them.
Importantly, a correlation between high uninsurance rates and an increasing COVID-19 burden does not mean below-average insurance coverage is driving infections. Instead, a complex constellation of overlapping factors, including politics, might be at play.
"When we think about the policy choices states have made, which would leave a state in a place to have high uninsured rate -- things like not expanding Medicare and Medicaid programs and having more restrictive Medicaid programs in the first place -- are political choices that tend to align on the right side of the political spectrum," Radley said.
"I think there are a lot of undercurrents that are driving high uninsured rates and the high case rate," Radley added.
The reality of being uninsured during a pandemic
Having a high rate of uninsured residents is bad enough during normal times, experts say, but it's especially harrowing during a pandemic.
Hospitals providing intense levels of COVID-19 care to uninsured patients won't be reimbursed at the same rate that they would be for patients with insurance. Assuming they survive, those uninsured patients will likely face medical bills for their hospital stays, whether they can afford them or not, Radley explained.
There's also a circular phenomenon in which people without insurance, or who are underinsured, may be less likely to seek timely care or get tested in the first place.
"I can see a scenario where it would create a spiral," Radley said.
Compounding that delayed care is the fact that people who don't have health insurance are more likely to be in high-risk groups, Brownstein explained. He pointed to a preprint study he worked on, which has not yet been published in a peer-reviewed journal, which found that "vaccine deserts have more residents with self-reported COVID-19 exposures and pre-existing conditions as well as more individuals who lack health insurance."
"If you have increased risk in those populations, it's not just about increased cases, it's increased hospitalizations and deaths," Brownstein said.
The most current data available on insurance rates from the American Community Survey data is from 2019, meaning it doesn't include the pandemic. But while experts feared that job loss during the pandemic would lead to higher uninsurance rates, Radley said that based on informal surveys, it doesn't appear that those fears have come to pass. He expects 2020 rates to reinforce similar patterns to the 2019 rates.
"I would bet you that these are vast underestimates, because those that are uninsured are unlikely to get testing -- either have access or be able to get testing covered," Brownstein said. "The patterns that you're witnessing might be even stronger if testing was equitable."
"If we're not taking care of fundamental issues of access to care at the most basic levels, and then you have worse outcomes among those patients because they didn't have that care or access to testing, and they end up in hospitals," Brownstein said. The end result: overflowing hospitals, which impact patients of all socioeconomic groups.
"Everyone suffers when you don't do the right thing in terms of equitable access to care."
(NEW YORK) -- Bars and restaurants are once again at the forefront of a polarizing business decision 16 months into the pandemic: Whether or not they should require patrons to wear masks inside or show vaccination status in order to dine safely.
Parts of the country are bracing for change after the Centers for Disease Control and Prevention (CDC) recommended Wednesday that vaccinated Americans wear masks indoors in areas with high COVID-19 transmission rates due to the increasing spread of the delta variant. The agency did not publish new research but cited, “CDC COVID-19 Response Team, unpublished data, 2021."
From coast to coast the restaurant industry has been hard-pressed to follow ever-changing health protocols throughout the pandemic to keep both staff and customers safe, but even with 49.5% of the country fully vaccinated, according to the Mayo Clinic, there is not a one-size-fits-all solution.
Restaurateur Danny Meyer, CEO and founder of Union Square Hospitality, announced Thursday that his restaurants in Washington, D.C., and New York City will require patrons dining and drinking inside to show they have been fully vaccinated starting Sept. 7. Guests can bring the physical COVID-19 vaccine card, a New York State Excelsior Pass, relevant state-provided vaccine pass, or a photo of their vaccination card to share upon arrival.
Although it's also part of his group, the Shake Shack founder said the policy does not yet extend to the popular burger chain.
"As everything opened up, there was a lot of reason for cautious optimism, but the increase of the delta variant infection rates is causing alarm for many," Andrew Rigie, executive director of the NYC Hospitality Alliance, told ABC News. "Some restaurants have or will implement vaccination policies for workers and in some cases customers, but that poses challenges."
Proof of a vaccine or facial coverings are ultimately up to the business owners who are looking out for the best interests of workers and the communities they serve.
For specific restaurants such as ones in a community with lower vaccination rates, Rigie said "different restaurants are situated differently and have different abilities. If most of your customer base is vaccinated and you have resources to check vaccination status, it's not easy, but it's easier than being a small business in a community with hesitancy or lower vaccine rates."
He added, "Collectively I think we understand we need to do everything possible not to revert to new mandates and restrictions after the restaurant industry has been economically devastated so far."
For first-time restaurant owner Patricia Howard, who opened an intimate seafood restaurant Dame to rave reviews in June, she said she has "anxiously watched the infection rate creep back up" and wants to remain vigilant for both diners and staff.
"We can't control whether the person next to us on the subway is wearing a mask, but we can control who gets to come through our doors at Dame," she told ABC News. "With two members of our staff immunocompromised and the very small size of our space, it is better to air on the side of caution. We were nervous about potential backlash, but once the city announced all municipal workers are required to be vaccinated, we felt more confident that it's the right thing to do regardless of the response."
The small team at Dame emailed diners who had upcoming reservations earlier this week about requiring proof of vaccination and Howard said they "only had to cancel a few reservations, due to one or more guests being unvaccinated thus far." She added that nearly all guests have been appreciative and supportive with hundreds of unexpected replies "thanking us for keeping our community safe, saying it makes them even more excited to dine at Dame, and hoping other restaurants follow suit."
In California, even before the latest CDC guidance, some bars in Los Angeles County, as well as the Bay Area, have taken preventative steps, asking for proof of vaccination or a negative COVID test 72 hours before dining.
Starting Thursday, bars that are part of The San Francisco Bar Owner Alliance may ask customers who wish to be inside to show proof of vaccination. While not mandated by the government, Ben Bleiman, president of the local industry group and owner of Soda Popinski's and Teeth bars, said this is a step they needed to take "to protect our staff and families."
Other industry leaders like Oregon-based Erika Polmar, executive director of the Independent Restaurant Coalition, stressed that this new wave of rules and recommendations could become "confusing and burdensome" for both restaurants and diners.
"It's really challenging to walk into one place and not see a mask mandate and then just a block or two away the mask rules are different," Polmar explained. "The requirements vary county to county and the public doesn't know where a county line is."
Polmar emphasized that if diner attendance dips again, government financial assistance will be crucial and she is imploring Congress to quickly allocate money again for the Restaurant Revitalization Fund.
"I think if you were to talk to any restaurant owner across the country they would be even more heartbroken that they're not seeing the replenishment of the RRF" despite support in the House and Senate, she said. "The urgency isn’t being acted upon."
She continued, "Restaurants are accepting the hard truth that Congress might not act until September and that's amplifying the devastation they're feeling."
(NEW YORK) — With the country in the midst of a new nationwide resurgence of coronavirus infections and hospitalizations, misinformation about the effectiveness of the vaccines has been proliferating on social media, with increased attention falling on the rare number of vaccinated people ending up in the intensive care unit (ICU). However, according to dozens of hospitals across the nation surveyed by ABC News, very few fully vaccinated people are actually ending up severely ill and in the ICU with COVID-19.
And experts say that those that do, tend to be frail or have conditions that interfere with the vaccine's effectiveness at producing protection.
ABC News contacted 50 hospitals in 17 states, and asked them to share data on their ICU wards' current COVID-19 patients, including their vaccination status. In the surveyed hospitals, ABC News found that the overwhelming majority of COVID-19 patients currently being treated in ICUs were unvaccinated.
Of the 271 total COVID patients in the surveyed ICUs, 255 patients, or approximately 94%, were unvaccinated against COVID-19 in ABC News' snapshot in time.
Further, of the 16 vaccinated individuals receiving care in the ICU, almost all suffered from comorbidities and other health problems, such as cancer or weakened immune systems. ABC News only heard of one otherwise healthy and fully vaccinated individual, with no reported underlying conditions, who was in the ICU.
According to the CDC, "vaccine breakthrough cases are expected," and, as a result, "there will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19." But data about ICU patients' vaccination status is not regularly reported or readily available on the federal or state level.
"The current surge of COVID-19 is driven by those who have elected not to be immunized. We will continue to see the lopsided impact of COVID among the unvaccinated, as they represent the vast majority of severe illnesses, hospitalizations and deaths," said ABC News contributor Dr. John Brownstein, chief innovation officer at Boston Children's Hospital.
The hospital sampling also appears to be reflective of a national trend. According to the White House COVID-19 Task Force, severe breakthrough infections remain uncommon, and nearly all of the patients who are currently hospitalized with COVID-19 -- 97% -- are unvaccinated.
Dr. Lew Kaplan, past president of the Society of Critical Care Medicine and professor of surgery at the University of Pennsylvania's Perelman School of Medicine, said that the ABC News survey data "provides crystal clear guidance regarding the SARS-CoV-2 delta variant -- that vaccines work.”
Furthermore, said Kaplan, the very fact that "the overwhelming majority of hospitalized critically ill patients with this viral variant are unvaccinated, should drive our nation to relentlessly pursue vaccination of every eligible individual."
"It is our duty and our privilege to save lives," Kaplan said. "The COVID-19 vaccine is staggeringly effective in helping us keep people at home and alive."
Front-line workers support the numbers
ABC News' findings are also supported by local data. In Springfield, Missouri, county health officials reported this week that since vaccines became available, 96.5% of those who have died of COVID in the community were not fully vaccinated.
Mercy Hospital nurse Emily McMichael said the county's findings are supported by what she's been seeing.
"These patients are a lot sicker and a lot younger than what we saw the last go around, so it's just really sad to see," McMichael said. "And a lot of the population is unvaccinated."
In Alabama, which has the lowest vaccination rate in the country, 94% of current COVID-19 hospitalized patients are unvaccinated according to state statistics -- and hospital admissions are six times higher than they were just a month ago, as health care workers report an influx of COVID-positive patients in need of care.
The University of Alabama at Birmingham Hospital has seen "an explosion of cases," with the number increasing tenfold in the last three weeks, according to Dr. Kierstin Kennedy, chief of hospital medicine.
The patients who are currently hospitalized, Kennedy said, are younger than those who were hospitalized during the last surge -- but unfortunately, they are just as sick. The vast majority of those patients are unvaccinated, she said.
Similarly, in Florida, state statistics show virus-related hospitalizations are nearly at their highest point since the onset of the pandemic, with more than 1,200 COVID-19 patients being admitted to the hospital every day.
"This is heartbreaking because all this could have been avoided; this is unnecessary human suffering that we are witnessing right now," said Dr. Seetha Lakshmi, medical director of the Global Emerging Diseases Institute at Tampa General Hospital, where she said "almost all" patients are currently unvaccinated.
Another Florida physician said he believes low vaccination rates are one of the driving factors behind the state's significant increase in COVID-19 patients.
"The vaccine is really protective in terms of being hospitalized or in terms of dying, and the people we're seeing that are sick, ending up on ventilators and ending up hospitalized, are unvaccinated patients," Dr. David Wein, emergency room physician at Tampa General, told ABC News.
Few severe hospitalizations for fully vaccinated individuals
Just a month ago, 37-year-old Amanda Spencer, an unvaccinated mother of two from Ohio, became infected with the virus while on a family vacation in Florida. She spent 16 days in a Florida hospital, 11 of them in a medically induced coma.
"I never dreamed that I would go through what I did, and that I would be that close to leaving my family," Spencer told ABC News.
Spencer said that prior to her illness, she had not necessarily been against getting the vaccine, but had found it difficult to make time to get the shot -- and to some extent had been afraid of the side effects.
However, her illness has shifted her perspective.
"Having gone through what I've gone through, I would have much rather gotten the vaccine, and maybe had a couple of side effects," said Spencer, adding she now plans to get the vaccine as soon as she is able. "Everybody has a right to decide what's best for them, but my advice is that if you have an underlying condition, whether it be asthma or any type of respiratory issue, I would definitely consider getting the vaccine.”
Although patients with underlying conditions are typically at higher risk, Dr. Kennedy said that from what she has seen, "the patients that have comorbidities and are vaccinated are not getting sick enough to require intubation."
And several hospitals contacted by ABC News reported that often, vaccinated COVID-19 patients in the ICU are being hospitalized for reasons other than COVID-19.
"You may see COVID-vaccinated patients in the ICU, but many of them are not in the ICU for severe COVID," Dr. Jennifer Leonard, an ICU physician at Missouri's Barnes Jewish Hospital, told ABC News. "They have mild or asymptomatic COVID and they require an ICU bed for another disease or indication.”
Overall, Kaplan said the ABC News survey data demonstrates that "even if you are vaccinated you can still become ill, but it is so much less common that the benefit of being vaccinated is vast. It is incredibly protective and it protects you, the people you love, and the people with whom you work."
Although the vaccine may not prevent 100% of illness, it lessens the impact for most, Kaplan said.
"Fully vaccinated individuals are less likely to become severely ill because they've prepared their immune system," he said.
Kennedy said that she combats vaccine hesitation by explaining to patients that, at this point, there are millions of people around the world who have received the vaccines, with minimal side effects. The long-term side effect of vaccination, she tells her patients, is that they are not dying from COVID-19.
And what about the commonly stated concern of people who are waiting to get the vaccine because they don't want to be guinea pigs?
Kennedy said she tells her patients that "if you don't want to be a guinea pig, then don't get COVID."
ABC News' Sony Salzman, Eric Strauss, Dr. Alexis E. Carrington, Dr. Chidimma J. Acholonu, Dr. Odelia Lewis, Dr. Priscilla Hanudel, and Dr. Jay Bhatt contributed to this report.