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COVID-19 canines: How dogs may help sniff out the coronavirus in humans

JPecha/iStockBy MINA KAJI and AMANDA MAILE, ABC News

(HELSINKI) -- They say you can't teach an old dog new tricks, but trainers in Finland claim 8-year-old greyhound mix Kössi learned to identify a scent associated with COVID-19 in just seven minutes.

Helsinki Airport welcomed Kössi and nine other "coronavirus-sniffing dogs" as part of a pilot program this week meant to "speed up the process of identifying those infected with COVID-19."

"We are among the pioneers," Helsniki Airport director Ulla Lettijeff said. "As far as we know, no other airport has attempted to use canine scent detection on such a large scale against COVID-19."

Four dogs will work at the airport during a shift, but passengers getting tested will not have direct contact with the dogs.

They will be prompted to swipe their skin with a wipe and drop it into a cup, which is then given to the dog to smell.

"The service is mainly intended for passengers arriving from outside the country," Susanna Paavilainen, CEO of WiseNose Ry, University of Helsinki's DogRisk research, explained.

The airport said that according to preliminary tests conducted by a research group at the Faculty of Veterinary Medicine at the University of Helsinki, "dogs are able to smell the virus with almost 100% certainty."

In the U.S., testing is still underway to determine if dogs can truly sniff out the coronavirus. The University of Pennsylvania's School of Veterinary Medicine (Penn Vet) launched a pilot study in April that would take a group of dogs and expose them to COVID-19-positive saliva and urine samples in a laboratory setting.

Once the dogs learned the odor, investigators would then see whether or not the animals can discriminate between COVID-19 positive and negative samples in a lab setting, according to Penn Vet.

While the results of the study have not yet been released, Penn Vet called it "pioneering" saying it "sets the stage for dogs to be a force multiplier in the mission to detect COVID-19, particularly among asymptomatic patients, or hospital or business environments where testing is most challenging."

Both the Transportation Security Administration (TSA) and U.S. Customs and Border Protection (CBP) told ABC News they are not training their canines to detect COVID-19.

Copyright © 2020, ABC Audio. All rights reserved.


How much black licorice is too much and why a sweetening compound can be bad for adults

ajcespedes/iStockBy KELLY MCCARTHY, ABC News

(NEW YORK) -- As people prepare to dig into their favorite Halloween candy, there's one treat with a new consumption warning for adults.

According to the U.S. Food and Drug Administration, eating black licorice in excessive amounts can prompt low potassium levels and trigger a series of irregularities and health issues.

"If you're 40 or older, eating 2 ounces of black licorice a day for at least two weeks could land you in the hospital with an irregular heart rhythm or arrhythmia," the FDA said in a statement about the candy that contains glycyrrhizin (glycyrrhizic acid) -- the sweetening compound derived from licorice root.

Alexandra Lambert, D.O., M.P.H., an ABC News Medical Unit contributor, explained that the compound can be found in other candies and supplements, but it's most commonly seen in the old-school candy with a distinct anise aroma.

"This case may be an extreme example of the deleterious effects of black licorice as there are not many other cases in the literature," Lambert added.

"Not all licorice-flavored foods contain this compound," she said. "Glycyrrhizin can cause low potassium levels in the body which can lead to abnormal heart rhythms, high blood pressure, swelling, lethargy and congestive heart failure in some people."

In some cases, Lambert added, abnormal heart rhythms could be fatal.

While many products with licorice don't disclose how much of it is contained per ounce, the FDA regulates that soft candy can only contain up to 3.1% glycyrrhizic acid.

Black licorice can "interact with some medications, herbs and dietary supplements," Lambert continued. "Experts believe that potassium levels usually return to normal without causing permanent health problems when consumption of black licorice stops."

According to the National Institutes of Health, the root of the low-growing shurb that's native to South Africa has a "long history of use as a folk or traditional remedy in both Eastern and Western medicine."

Although the NIH cites some cases of use for treatment of heartburn, stomach ulcers, bronchitis, sore throat, cough and some infections caused by viruses, the agency said, "there are insufficient data available to determine if licorice is effective in treating any medical condition."

For big black licorice fans, the FDA recommends the following advice: "No matter what your age, don't eat large amounts of black licorice at one time. If you have been eating a lot of black licorice and have an irregular heart rhythm or muscle weakness, stop eating it immediately and contact your health care provider. Black licorice can interact with some medications, herbs and dietary supplements. Consult a health care professional if you have questions about possible interactions with a drug or supplement you take."

Copyright © 2020, ABC Audio. All rights reserved.


Proper installation' of car seats saves kids' lives, says mom and car seat expert

Courtney IlarrazaBy GENEVIEVE SHAW BROWN, ABC News

(NEW YORK) -- When Courtney Ilarraza's minivan was totaled by a car traveling 60 mph on the three-mile trip from the beach to her home in Brooklyn, New York, her three children walked away unscathed.

Despite the intensity of the collision, the then-3-year-old in a five-point harness was just fine.

"I remember buckling her in and she was saying the straps were too tight," Ilarraza told Good Morning America. "But I told her that's how it was supposed to be."

This week is Child Passenger Safety Week, which focuses on the proper use of car safety seats for children.

Ilarraza, who runs Baby Bodyguards, a baby-proofing company that also offers clinics and private sessions on proper installation of car seats, told GMA that the car seat itself is less important than how it's installed. She is also a certified passenger safety technician.

"All car seats manufactured in the U.S. are held to the same crash-test standards," she said. "The difference is the bells and whistles, some of which have to do with the ease of installation." For example, the Britax Click Tight has a light that turns green when the seat is installed properly. "It's super user friendly," she said.

"Someone like me can get a less expensive seat because I know how to thread the straps and how to install it properly," Ilarraza told GMA. But when she makes recommendations, she said, she does advise parents to buy the seats that make it crystal clear they've been installed properly."

"Installation is crucial," she said. "Say you get your car seat professionally installed the first time it goes in the car, but then your kids throws up in it and you need to remove it to clean it. You want a seat that anyone can put back in the car correctly and safely."

Technology has come a long way, she said.

The American Academy of Pediatrics changed its car seat recommendations in 2018 to keep children in rear-facing seats as long as possible. It had previously suggested rear-facing until the age of 2.

"It's based on size rather than age," Ilarraza said. "And that varies between each manufacturer."

As for specific car seat recommendations, Ilarraza said the Britax Click Tight, the Uppababy Mesa and the Graco 4ever all-in-one are all easy to install. Once the child is in the seat, it's important the chest piece goes across the nipple line. "It's the perfect position to absorb impact," she said.

Finally, never use a second-hand seat, Ilarraza advised. "You don't know the history of the seat," she said, and "any seat involved in a car accident needs to be discarded and replaced."

More expert tips from Alisa Baer, known as The Car Seat Lady:


"In my 22 years experience helping parents install more than 15,000 car seats, the most common mistakes I see are 'loose and lose,' the car seat is installed too loosely in the car, and the harness straps are too loose on the child's body," Baer told "GMA." She sent her top three tips for safe car seat installation.

1. Installation: My inside/outside technique can help parents achieve a tighter installation with the majority of car seats on the market -- both rear and forward-facing. And, using the vehicle seat back recline trick in combination with the inside/outside technique can provide additional help getting the car seat tight with less of a workout required.

2. Harnessing (which is installing the child in the seat...):
When buckling a child, parents often don't realize that moving the chest clip up to armpit level is the final step, and that while tightening the straps you want to keep the chest clip low, and pull upwards on the chest straps to gather the slack and then pull the tail to remove the slack.

3. Tethers:
Every forward-facing car seat -- where the child uses a five-point harness as their restraint -- has a tether strap that secures the top of the car seat to an anchor in the back of the vehicle. Every forward-facing car seat is safer when the tether is used. Regardless of whether the forward-facing car seat is installed with the lower anchors (LATCH) or seat belt, always use the tether. Tethers decrease how far forward the child's head moves in a crash by at least 4-6 inches, which greatly reduces the risk of brain and spinal cord injury. Not sure where the tether anchors are in your vehicle? Check here!


Copyright © 2020, ABC Audio. All rights reserved.


Women more likely to experience depression, anxiety, new CDC data shows

martin-dm/iStockBy SASHA PEZENIK, ABC News

(NEW YORK) -- Before the COVID-19 pandemic pushed systemic inequalities and unprecedented stress levels to a breaking point, a crisis in American mental health already loomed.

New data released by the Centers for Disease Control and Prevention's National Center for Health Statistics surveying nearly 32,000 adults and 6,800 children across more than 33,000 households reveals that in 2019 women were more likely to experience symptoms of depression and anxiety than men, and more likely to receive counseling or therapy, or take prescription medication, to promote their mental health.

While white and Black adults reported experiencing symptoms of depression equally, white adults were more likely to receive concurrent mental health treatment. Hispanic adults were the least likely to have received any mental health treatment.

"It's a definite disparity we noticed," Emily Terlizzi, study co-author and health statistician at the NCHS, told ABC News. "These are good pre-COVID benchmarks, and we want to look now and see, do they change in 2020?"

Who needs help -- and who is getting it -- has become even more imperative during a global health emergency. Experts say the solution must first address a structural imbalance in who feels they have the right to ask for support.

"Even outside of the pandemic, women seem to be uniquely vulnerable to depression," said Dr. Pooja Lakshmin, a clinical assistant professor of psychiatry at George Washington University School of Medicine who specializes in women's mental health. "I think there's more permission for women to say, 'Hey, I need help.' That framework exists for women in a way where for men it's much harder to do that. But at the same time, there are still gaps in our mental health system."

Black and Brown communities especially have faced a centuries-long climb toward health equity, experts say.

"You're not supposed to tell strangers your secrets," Alysha Pamphile, 34, a Haitian American video producer based in New Jersey, told ABC News. "There's such a taboo around therapy, and the space of being vulnerable, a sense of weakness, when in fact, it's quite the opposite. But we weren't given the language to do that; we hadn't been allowed that grace."

"The root structure of psychology, and much of what's been baked into even the foundations of mental health, has been stigmatizing and not at all supportive in meeting the needs of communities of color. Beyond that, it is just a very foreign concept," Dr. Joy Harden Bradford, a clinical psychologist based in Atlanta, told ABC News.

She founded "Therapy for Black Girls," a blog meant to make space for Black women to talk about their mental health.

"We convince ourselves we're supposed to be unbreakable even if we're hurting," Bradford said. "So we need to instill that it's OK to not be OK for communities of color -- but even more importantly, to realize when that's so and actively seek support."

Normalizing mental health treatment and availing it to those in need begins with fleshing out an emotional lexicon for groups that have long been left out of the conversation, experts say. Women may be more likely to experience symptoms of depression, but they also may be more likely to admit it. A Black man may not feel equipped to ask for help, even if he feels the need.

"What existed pre-COVID, and certainly exists now, is still tremendous cultural mistrust, on behalf of not just African Americans, but other racially ethnically marginalized people," Dr. Rheeda Walker, professor of psychology at the University of Houston and author of The Unapologetic Guide to Black Mental Health, told ABC News.

"And the way that we assess depression could allow us to miss depression -- in men, for example," Walker said. "And then also, men tend not to use emotional words as much as women do or disclose how they're feeling."

And symptoms can present uniquely: psychosomatic pain can be the body's sly way of indexing emotions we don't feel comfortable feeling.

"Anxiety could show up as a headache or a stomach ache, and you don't necessarily connect it to mental health," Bradford said. "We don't want to show the world we're weak, so that means that we can even have a hard time recognizing for ourselves when we have reached a breaking point."

Now amid a global crisis mode, there is further stress on the groups most vulnerable to the virus itself, most vulnerable to its socioeconomic impact and yet least likely to receive mental health support.

"Pre-COVID, we've already seen nationally increasing anxiety, people feeling overwhelmed, people hurting," Walker said. "Coronavirus kind of puts all of that on steroids because of the level of disruption."

What COVID-19's ravages have compelled, experts say, is more candid confrontation of social injustice and mental health disparities.

"Parallel to this pandemic has been this racial awakening, and I think now we're forced to stare it down," Pamphile said. "And I was forced to meet myself. It's been a beautiful as well as a traumatic experience. Now that we're forced to sit between our four walls, where there's nothing but mirrors -- on top of looking at the world wide web, social media, where we're seeing ourselves be murdered -- we have no choice but to start understanding that help is OK."

"This is not new human suffering, but now the importance of mental health in these contexts has been brought to people's attention in a way I haven't seen before," Lakshmin said. "What remains to be seen is whether we develop the resources to meet that need."

Copyright © 2020, ABC Audio. All rights reserved.


Coronavirus transmission heightens concerns surrounding ventilation in schools

smolaw11/iStockBy SOPHIE TATUM, ABC News

(NEW YORK) -- As concern grows among researchers about the extent to which the novel coronavirus might be transmitted through the air, advocates and educators said they have long been concerned about poor air circulation due to outdated ventilation systems.

In June, Terrie Brady, president of Duval Teachers United, walked through the halls of some of the schools in her Florida community, and said she saw "dirt hanging out of the air ducts."

"It was just filthy. So, if you have dirty air vents or air ducts in classrooms, you know that they haven't been cleaned," Brady told ABC News.

"It was an issue before COVID, but I think it's heightened under COVID," said Andrew Spar, president of the Florida Education Association.

A group that represents educators in Texas has been surveying members across the state regarding concerns related to COVID-19 safety procedures. Clay Robison of the Texas State Teachers Association said that as of Monday, the second-highest number of COVID-19-related complaints were for inadequate ventilation or ventilation equipment, behind complaints that schools did not make appropriate accommodations for high-risk employees.

"The inadequate ventilation or ventilation equipment part was cited 477 times out 788 respondents," Ovidia Molina, Texas State Teachers Association president, told ABC News in a phone interview.

"So, it's a really big concern. It's not just the complaints about having dirty filters that school districts can change out as soon as they've been told. But it's the sort of feeling of, you know, waiting until it's a problem to fix it," she said.

Molina said school districts in the state don't have the money to keep up with the changes that need to happen.

"We know that the ventilation systems are very expensive and they're one of the last things to be fixed. You know, pretty much until they get broken," Molina said.

Brady said Duval County, Florida, has some of the oldest schools in the state -- some buildings are 50 years or older. She said most of the air conditioning units are "so outdated and antiquated," that, "even if we wanted to get the specialized air filters that they have now to combat some of the particles, they won't even fit in our units and our handlers."

Brady said the group has pushed for the district to continuously clean out air ducts and air filters, but Brady said it is "absolutely" a concern for her district, noting that some teachers along with parents have purchased air purifying machines for their classrooms.

"Air purification is a big deal. And the thing is, is that's probably one of your most expensive expenditures you could possibly have," Brady said.

In June, a report released by the Government Accountability Office found that about half of public schools in the United States need to update or replace building systems, including about 36,000 school buildings that need updated heating, ventilation and air conditioning systems.

The report raised alarm bells at the time from House Education and Labor committee Chairman Bobby Scott, D-Va., who said, "Even before the COVID-19 pandemic, outdated and hazardous school buildings were undermining the quality of public education and putting students and educators at risk."

"Now, the pandemic is exacerbating the consequences of our failure to make necessary investments in school infrastructure," he said.

On Tuesday, White House Coronavirus Task Force member Dr. Anthony Fauci said it's a reasonable assumption that there is some aerosol transmission of the virus -- raising more questions about virus transmission in the classroom.

The Centers for Disease Control and Prevention's guidance for safely reopening schools also advises ensuring that ventilation works properly, in addition to increasing outdoor air circulation when possible, by doing things like opening windows and doors.

However, Spar said that it's not as easy as just opening windows, either -- especially in Florida where it can get over 90 degrees.

"Just a week or two ago, we were had heat indexes of over 100 degrees," Spar said. "So, you know, opening a window or being outside is certainly not something that was advisable."

Because of this, Spar said schools rely on air conditioning units.

"And you hope that the air conditioning units have adequate filtration, that they're using high-quality filters. But unfortunately, in districts where money is tight, that's not always the case," he said.

Copyright © 2020, ABC Audio. All rights reserved.


Bioethicists condemn DIY COVID-19 vaccine efforts

simon2579/iStockBy SONY SALZMAN, ABC News

(NEW YORK) -- Across the country, a small handful of scientists are brewing up their own homemade and unproven COVID-19 vaccines and giving them to friends, family and themselves.

These scientists hail from disparate groups. Some are shadowy and anonymous, while others are highly organized and Ivy-league affiliated.

"It's actually simpler than most recipes in home cookbooks," said Preston Estep, chief scientist and co-founder of a DIY effort backed by a Harvard geneticist.

Estep said he hopes that his group's unapproved vaccine, which is inhaled through a nasal spray, might give people sheltering at home more confidence and protection.

"In my view, it is unethical to tell people to wait two years for something that's available today," said another DIY proponent, entrepreneur and microbiologist, Johnny Stine, in an email to ABC News.

Still, another group says it won't name its handful of members for fear of Food and Drug Administration retribution.

These DIY groups are united in their belief that traditional vaccine development is too long and cumbersome, and society could have access to a potential vaccine now.

Six months into the COVID-19 pandemic, there are at least three vaccines from major pharmaceutical companies in late-stage trials, but we are still months away from having a vaccine widely available.

But there's one problem: none of these DIY enthusiasts know for sure if their vaccine actually protects people from COVID-19, or whether it's safe. And without carefully controlled experiments, they'll never find out.

"I'm not opposed to speed," Arthur Caplan, Ph.D., founding director of the division of medical ethics at New York University Langone Medical Center said. But the DIY vaccine effort, Caplan said, is "reckless, driving drunk."

Now, Caplan is among a growing chorus of bioethicists condemning the DIY vaccine movement.

"A DIY vaccine is a bad idea," said Dr. Ruth Faden, founder of the Johns Hopkins Berman Institute for Bioethics. "Unless -- and this is the big unless -- [it] was connected with some mechanism for moving this into the regular order."

The DIY nature of these experiments means no one is formally keeping track of what happens to people who take these vaccines -- whether they get sick, or if they're protected from coronavirus infection, explained Jennifer Miller, Ph.D., an assistant professor at Yale School of Medicine and founder of Bioethics International and the Good Pharma Scorecard.

That means we're gleaning little meaningful knowledge about whether the vaccines work, Miller said.

"One of the main reasons why it's OK to medically experiment on humans is the potential to create generalizable knowledge and advance the common good," Miller said.

But with DIY vaccines, there's no standard ethics review board -- a 21st century safeguard for human experimentation.

"Research on humans is never OK without an ethics review," said Miller. "People tend to think that ethics codes and regulations are for barbarians ... [but] those codes are for everybody. Even if you are a Nobel prize winner, you are not above the ethics codes."

The most recent critique, published Thursday in the journal Science, said these efforts are not only unethical, but if unproven vaccines are sold to consumers they also could also be illegal.

"Taking information that you found in some dark corner of the internet but using it to develop your own materials and needing to ship materials or reagents across state lines -- that is interstate commerce and is what triggers FDA oversight," lead author Jacob Sherkow, law professor at Illinois College of Law, said in a statement. "At that point, that's essentially where the FDA can stop you."

But the proponents of DIY vaccines argue that there's an ethical obligation to release a vaccine that can be used immediately even if unproven for efficacy and safety, rather than waiting for the traditional review process that includes a series of FDA-mandated safety and effectiveness studies that can take years to complete.

"I don't have the millions it takes to even get to the FDA [doorstep] nor would I have the patience to wait two years for a vaccine to a virus that was killing people today," said Stine, who made headlines in May when he was hit with an FDA warning letter for selling his DIY vaccine.

In June, the Washington attorney general filed a lawsuit against Stine, which he later settled without admitting wrongdoing, but he agreed to repay upon request any of the 30 people he had vaccinated.

Estep doesn't sell his vaccine, but believes bioethicists critical of the DIY movement "misunderstand the situation."

"All they are talking about is the risks, but that's a completely unbalanced perspective," Estep said. "They're not presenting the risks of not taking [a DIY vaccine] which are substantial and clear and happening every day."

But bioethicists warn the potential damage caused by DIY vaccines goes beyond each person who chooses to participate. These efforts could harm public trust, eroding the already fragile credibility of legitimately tested and vetted vaccines.

"Having a small group of scientists and their admirers develop something in the garage, so to speak, is just another avenue for having the public be leery of what is said about vaccines," said Caplan.

"Look, self-experimentation is an old and sometimes, in some circles, revered tradition in the ethics of research," Faden said. But "this is not like other kinds of do-it-yourself science. The stakes here are enormous. We can't get this wrong."

Copyright © 2020, ABC Audio. All rights reserved.


Younger people more likely to believe COVID-19 misinformation, Harvard survey finds

narvikk/iStockBy CATHERINE THORBECKE, ABC News

(NEW YORK) -- Younger people are more likely to believe false claims related to the novel coronavirus than older people, according to a new survey released Tuesday by a team of researchers at Harvard University, Rutgers University, Northeastern University and Northwestern University.

The survey of nearly 22,000 individuals from all 50 states comes as a slew of misinformation surrounding COVID-19 is spreading online as the pandemic rages on, and as health officials express worry over rising cases among younger Americans.

The researchers assessed respondents' acceptance of 11 of the most popular false claims that have been circulating in cyberspace and beyond since the beginning of the pandemic -- including that the disease was caused by humans eating bats, false prevention claims and more. It was conducted between Aug. 7 and 26.

People under the age of 25 had an 18% probability of believing a false claim, compared to only 9% of people over 65, the researchers found.

"Indeed, across the 11 false claims, we find a clear pattern: the older the age group, the lower the average level of belief in false claims," the study states.

Respondents in the age group of 25 to 44 were 17% likely to believe a false claim and the group of 45 to 64 had a 12% probability of believing a false claim.

The researchers also found insights into some of the most-believed false claims swirling among various age groups.

Some 28% of respondents under the age of 25 believed that humans originally contracted COVID-19 by eating bats, according to the survey. Only 6% of respondents age 65 or older believed that same false claim.

Moreover, 25% of respondents under the age of 25 believed that the virus was created in a Chinese weapons lab and that taking antibiotics protects against COVID-19.

Another troubling find was that 24% of those under 25 believed that only people over the age of 60 are at risk from COVID-19. This figure was slashed in half to 12% among those over 65.

The Centers for Disease Control and Prevention released the results of a new study on Wednesday showing the demographic of people infected with COVID-19 has shifted significantly toward young people and away from older adults in recent months. The median age of those infected declined from 46 in May to 38 in August, according to the study, and 20% of all confirmed cases in July and August came from individuals 20 to 29 years old.

In June, House Speaker Nancy Pelosi, D-Calif., put the blame on social media giants for many of the bogus COVID-19 claims, claiming they were even profiting off the misinformation.

Some have also blamed President Donald Trump, who has faced scrutiny from health officials and more for some of his false claims about the disease.

Copyright © 2020, ABC Audio. All rights reserved.


Johnson & Johnson becomes 4th manufacturer to begin Phase 3 trials for COVID vaccine

JHVEPhoto/iStockBy DAVE HARRISON, ABC News

(NEW BRUNSWICK, N.J.) -- As the race for a safe and effective coronavirus vaccine continues, one manufacturer has announced a major step in the right direction.

American pharmaceutical company Johnson & Johnson said Wednesday it will be starting Phase 3 clinical trials, joining Moderna, Pfizer and AstraZeneca to become the fourth manufacturer affiliated with the U.S. government's Operation Warp Speed.

Phase 3 clinical trials mark an important sign of progress, as the trial is expanded to tens of thousands of volunteers and is generally the last phase before a product reaches the general public.

“Four COVID-19 vaccine candidates are in Phase 3 clinical testing in the United States just over eight months after SARS-CoV-2 was identified,” Dr. Anthony Fauci said in a statement.

“This is an unprecedented feat for the scientific community made possible by decades of progress in vaccine technology and a coordinated, strategic approach across government, industry and academia,” he said.

The trial, which will be funded jointly by the company and the U.S. government, will enroll over 60,000 participants in 215 locations across the U.S. and worldwide. This will make it the largest Phase 3 trial out of the four active vaccine candidates under Operation Warp Speed.

Johnson & Johnson also aims to accomplish several firsts in the vaccine arms race.

Its vaccine will be the first to require a single dose while its competitors use two doses to achieve the expected degree of immunity. Its storage requirements are also better-suited for an average doctor’s office or clinic, compared to Pfizer’s vaccine which needs deep-freeze storage.

“It is likely that multiple COVID-19 vaccine regimens will be required to meet the global need,” Fauci said. “The Janssen [Johnson and Johnson’s parent company] candidate has showed promise in early-stage testing and may be especially useful in controlling the pandemic if shown to be protective after a single dose.”

This vaccine uses an “adenovirus vector” -- a modified copy of a common cold virus to induce immunity to COVID-19.

Dave Harrison, M.D., is a pediatric cardiology fellow in Boston and a contributor to the ABC News Medical Unit.

Copyright © 2020, ABC Audio. All rights reserved.


Faster, cheaper COVID-19 tests in danger of creating blindspot in data collection

South_agency/iStockBy DR. LEAH CROLL and SONY SALZMAN, ABC News

(NEW YORK) -- More than 100 million COVID-19 tests have been performed in the United States, according to the Centers for Disease Control and Prevention's COVID Data Tracker.

But the true number of tests is unknown because of decentralized accounting and the fact that not all tests were created equally.

"Testing has always been at the heart of how we get out of COVID, because without insights into where infection is spreading, you're flying blind. Our response is heavily based on test results, in terms of which phase of reopenings we're in and whether we have to go into lockdown," said John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News contributor.

The CDC only includes polymerase chain reaction, or PCR, tests in its count. These tests look for presence of the virus and are usually sent away from a doctor's office and processed in a large, centralized lab.

But increasingly, doctors' offices are offering a new generation of 15-minute rapid tests, which might not always be counted. A third type of test, antibody tests, also are excluded, but these tests show only if a person was previously infected -- not whether they're still contagious.

Keeping track of diagnostic testing at a national level is essential not only for accurately counting confirmed COVID-19 cases, but also for guiding our efforts to control the pandemic. Unfortunately, it seems that many states either don't report data from antigen testing to the CDC or are not keeping complete data on it.

There's no straightforward answer about whether rapid tests are counted, said Molly Polen, senior director of communications and public relations for the American Association for Clinical Chemistry. One of the most common types of rapid tests is called a nasal-swab-based antigen test -- not to be confused with an antibody test, which requires a blood sample.

"It looks like a number of states combine PCR and antigen testing, but same as with the antibody tests, not all states seem to report antigen test results," Polen added.

That's a problem because it means we may be significantly underestimating the number of people who have COVID-19 at any given time.

"There's a lot of confusion about what gets reported, when it gets reported and how it gets reported," Brownstein said.

Failure to report complete COVID-19 testing data goes against current federal guidelines, but just because doctor's offices across the country are required to report these newer "rapid" COVID test results does not mean they're actually doing so -- or doing so consistently.

The main problem is a lack of efficient and effective infrastructure for centralized data collection, said Blythe Adamson, an epidemiologist and former member of the White House Coronavirus Task Force.

"Different states may have different ways they operationalize clinical reporting to different health departments. CDC does not have a standardized infrastructure for all of this," Adamson said.

Keeping patchy testing data leaves public health officials in the dark as to the true burden of coronavirus-related disease in our country. Testing is the main tool for understanding community transmission, Brownstein added.

"So if there's testing but we don't have that data, that gives us major gaps in our understanding and it could force us into making public health decisions that are not aligned with the best possible evidence," he said.

The gap between the reported number and true number of COVID cases will only widen moving forward, as rapid antigen tests are rolled out by the millions.

Antigen tests are being used more and more because they're fast and cheap. They can produce a result in just a few minutes because they don't need to be processed in a lab, whereas PCR and antibody tests may take days. Antigen tests also are significantly less expensive.

There is even talk of using antigen tests at home, similar to pregnancy tests. That would mean we'd have to rely on regular people -- not health care professionals -- to report their own results, which could get complicated. What's more, many antigen tests results need to be confirmed with a PCR test, which could "open up a whole other Pandora's box," said Brownstein.

Testing needs to be ramped up to combat COVID-19, but data from testing needs to be more easily reportable and actionable -- more signals, less noise in the data.

"It requires more infrastructure and thought and care as we think about how to integrate all this data together," Adamson said.

Copyright © 2020, ABC Audio. All rights reserved.


New spa water-inspired canned drink could help people get some sleep

PepsiCoBy KELLY MCCARTHY, ABC News

(NEW YORK) -- As consumers trend toward health and wellness products, PepsiCo has plans to drift into the functional beverage sector with a new drink intended to help people catch some shut-eye.

Driftwell, which will be manufactured for e-commerce availability this December, "is a new enhanced water beverage designed to help you relax and unwind with L-Theanine to promote relaxation and de-stress," the company shared in a fact sheet with ABC News.

The spa-water inspired blackberry and lavender flavored non-carbonated, sugar-free, calorie-free beverage contains two main active ingredients known to help with sleep -- L-theanine and magnesium.

Dr. Leah Croll, a contributor to the ABC News Medical Unit, explained that both ingredients "are said to promote better sleep and help anxiety."

"We frequently prescribe magnesium or melatonin combination pills as sleep aids," she said, adding that magnesium has been studied more as an aid for cognition or anxiety than for sleep, but some studies have cited its potential as an effective sleep aid.

L-theanine, an amino acid sometimes found in teas and mushrooms, has fewer studies behind it than magnesium, Croll said.

Maya Feller, a registered dietitian nutritionist, told ABC News' Good Morning America that the more widely recognized nutrient and sleep promoter helps regulate nerves and muscles.

"Magnesium works by regulating neurotransmitters that send signals throughout the central nervous system," Feller explained. "The mineral is also involved in interactions between internal melatonin production and GABA (gamma-amniobutyric acid) production, both of which are involved in the regulation of the sleep wake cycle."

She explained that sleep aid manufacturers who use magnesium "know that this mineral is integral to hundreds of reactions within the body" and that having adequate levels of magnesium is "necessary for restful sleep."

Although Driftwell was developed before COVID-19, it's hitting shelves at a time when sleep is in short supply for many Americans who are struggling to adapt to work from home, burnout and stress during the pandemic.

About 45% of Americans reported lying awake at night because of stress and 21% report feeling more stress when they can’t sleep, according to the American Psychological Association.

"Americans are over-stressed and as a result have difficulty sleeping, but are often forced to choose between products with little efficacy or products that rely on heavy-handed ingredients meant to quickly put people asleep resulting in groggy aftereffects," a spokeswoman for PepsiCo and Driftwell told Good Morning America.

Individual dose needs for magnesium vary from person to person and can be affected by "substance use, age and overall health status," Feller said.

According to the National Institutes of Health (NIH), daily magnesium needs range between 310mg per day to 400 mg per day.

Feller reasoned that sleep supplements can help people meet their needed recommended intake, but said an excess of magnesium in "people who are sensitive" to it can cause unwanted gastrointestinal symptoms such as loose stools.

"In general, when choosing a sleep supplement look for ones without excess added sugars and unwanted ingredients such as preservatives and fillers," she suggested.

Feller has worked with a number of patients on what she called "sleep hygiene" and daily routines to help them get their bodies ready for bed.

Some of Feller's recommendations include setting a consistent bed time, turning screens off at least 60 minutes before bed, setting a time of day to consume the news -- ideally not to close to bed as it can be very stimulating -- and for those who are sensitive to caffeine, that they limit consumption to the early part of the day.

PepsiCo said it intends to "drive an essential wellness conversation in North America" with the understanding that relaxation and stress relief is a lifestyle shift for many consumers.

Driftwell comes in a 7.5-ounce mini can and will be available nationwide in a 10-pack online for a suggested retail price of $17.99.

Copyright © 2020, ABC Audio. All rights reserved.


How to protect yourself from low air quality, pollution amid raging wildfires

milehightraveler/iStockBy KARMA ALLEN, ABC News

(NEW YORK) -- With record wildfires raging throughout the West, public safety experts said it's critical for residents to protect their lungs from poor air quality.

Wildfire smoke is typically a harsh mix of gases and fine debris from scorching trees and plants, buildings and other material, according to the Centers for Disease and Control and Prevention.

The smoke can be harmful to both animals and humans, and people with preexisting lung conditions, children and pregnant women are especially at risk for becoming seriously ill from poor air quality. People with asthma are warned to keep their inhalers with them at all times when traveling to wildfire-prone areas.

Outdoor air pollution accounted for 4.2 million premature deaths worldwide -- mostly in low- or middle-income countries -- in 2016 due to stroke, heart disease, lung cancer and respiratory diseases, like asthma, according to the World Health Organization.

Here are a few simple tips from health experts on how to protect yourself from dangerous air pollution:

Monitor local air quality trackers

It's important to stay on top of daily air pollution forecasts in your area. Many cities provide forecasts to help residents navigate areas where air quality may be worse, especially neighborhoods where families were forced to evacuate due to wildfire danger.

Experts said online pollution tracking apps as well as local radio and TV weather reports are a good place to start. They also recommended the government's online tool at AirNow.gov to check for daily air quality warnings.

Be sure to familiarize yourself with the Environmental Protection Agency's Air Quality Index, which runs from 0 to 500. The higher the AQI value, the greater the level of air pollution and the greater the health risks. Anything below 50 represents good air quality, while an AQI value over 300 represents hazardous air quality, according to the EPA.

The index is color-coded and divided into six categories, making it easy for people to quickly determine if air quality is approaching unhealthy levels in their area. Each category corresponds to a different level of health concern.

Limit outdoor exercise

While it may be easier said than done for some sports enthusiasts, avoiding heavy outdoor activities is key when pollution levels are on the rise. For those desperate to meet step counts for the day, experts said walking indoors in a shopping mall or jogging up and down the stairs at home can be just as beneficial as walking thorough the park.

Naturally, indoor gyms and at-home exercise machines are also healthy alternatives to outdoor workouts when air quality is low.

Avoid heavy traffic areas

Even when air quality forecasts are good, car fumes from busy roads and highways can also worsen surrounding air quality. Experts said pollution from busy roadways can be felt up to one-third of a mile away.

If you're looking to work out outdoors on days when forecasts permit, experts say it's best to stay as far from busy roadways as possible, especially if you live in high-pollution areas.

Step it up at school

In addition to limiting outdoor play for children, consider connecting with other parents and caregivers who are also interested in protection from the air quality.

Try forming groups among parents and adults to encourage indoor play when quality is low and ask school leaders to consider more energy efficient policies.

The EPA's Clean School Bus Campaign is one of several U.S. school initiatives aimed at cleaning up emissions.

Use energy efficiently

In general, try to conserve as much energy as possible at home to cut down on long-term air pollution. Electricity and other sources of energy are major contributors to air pollution, but experts say reducing energy use can help improve air quality over time by curbing greenhouse gas emissions.

It's also important to encourage those close to you to do their share as well. Visit the EPA's website for a few tips to save energy, and money, at home.

Copyright © 2020, ABC Audio. All rights reserved.


Fact check: Trump's claim about whether coronavirus affects young people

Official White House Photo by Andrea HanksBy DR. LEAH CROLL, ABC News

(NEW YORK) -- President Donald Trump "falsely claimed" at a Monday night campaign rally that the novel coronavirus "affects virtually nobody" younger than 18 and mainly threatens seniors and people with underlying health conditions, according to the Washington Post.

Fact check:

Trump contradicted himself. In a March interview with Washington Post associate editor Bob Woodward, he acknowledged that "plenty of young people" were affected and admitted that he'd downplayed the risks of the virus. It's not clear exactly which age group Trump was referring to when he said that, but here's what we know about how COVID-19 affects kids and young adults:

Since March, evidence has been building that young people aren't as impervious to coronavirus as initially thought. According to the Centers for Disease Control and Prevention's Covid Data tracker, a recent analysis of 143,273 deaths revealed that 843, about 0.6%, occurred in people younger than 30, while 88, about 0.06%, occurred in people younger than 18.

In a recent MMWR report on COVID-19-related deaths in persons under 21, CDC researchers showed that nearly three quarters of SARS-CoV-2-associated deaths among infants, children, adolescents and young adults have occurred in persons aged 10 to 20 years, with a disproportionate percentage among those aged 18 to 20 years and among Hispanics, Blacks, American Indians and persons with underlying medical conditions.

Young adults also are at risk for severe complications of COVID-19. A recent JAMA Internal Medicine study of roughly 3,200 people ages 18 to 34 showed that 684 people, about 21%, required intensive care and 331, about 10%, required ventilators. Ninety people, about 3%, died.

The rates of poor outcomes in this population were lower than those reported for older adults with COVID-19, but higher than the rates reported for other diseases in young adults. For example, the death rate the authors found for COVID-19 in young adults is more than twice the death rate for heart attacks in the same age group. Morbid obesity, high blood pressure and diabetes were associated with greater risks of serious complications in this age group, which is similar to what we see in older adults. In fact, young adults with more than one of these conditions faces risks comparable to those observed in middle-aged adults without them.

In children and adults of all ages, pre-existing medical conditions undoubtedly increase the risk for severe complications and death from COVID-19. It's important to note that the cause of death in these individuals is COVID-19, not their underlying disease or old age.

Copyright © 2020, ABC Audio. All rights reserved.


We've hit 200,000 COVID-19 deaths in 6 months. What will the next 6 months look like?

Powerofflowers/iStockBy DR. LEAH CROLL, ABC News

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

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

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

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

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

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


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


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

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

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

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

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


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

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

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

Vaccine hesitancy and pandemic fatigue will be major hurdles


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

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

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

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

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

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

We know what we have to do moving forward


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

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

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

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


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

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

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

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

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

Copyright © 2020, ABC Audio. All rights reserved.


As US hits 200,000 COVID-19 deaths, experts warn of growing mental health crisis

Xesai/iStockBy KATIE KINDELAN, ABC News

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Copyright © 2020, ABC Audio. All rights reserved.


New CDC guidance on Halloween: Trick-or-treating, costume masks and Halloween parties discouraged

Rawpixel/iStockBy KATIE KINDELAN, ABC News

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

ABC News' Angeline Jane Bernabe contributed to this report.


Copyright © 2020, ABC Audio. All rights reserved.


Will President Trump be Re-Elected?