ABC News Health

UK COVID variant more transmissible but may not be more deadly, new studies indicate

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(LONDON) -- Two new British studies suggest that the B.1.1.7 variant is more transmissible than the original COVID-19 variants; however, it does not appear to be more deadly or cause more severe symptoms.

One of the studies, published in The Lancet Public Health, also reported a low rate of reinfection with B.1.1.7 in those who have recovered from previous COVID infections.

As was predicted, the Centers for Disease Control and Prevention is now reporting the B.1.1.7 strain to be the most dominant variant in the U.S., accounting for over 30% of cases in some states.

But B.1.1.7 isn't the only new, more contagious variant to emerge in recent months. Other so-called "variants of concern" include a variant first identified in South Africa (B.1.351) and a variant first identified in Brazil (P.1), according to the CDC.

Both B.1.351 and P.1 have taken over in South Africa and Brazil, respectively, and both have been found in low numbers in the United States. So why is the B.1.1.7 U.K. variant sweeping the country?

Experts say it's possible that B.1.1.7 is spreading in the U.S. because it is more contagious than original strains. It's also likely that B.1.1.7 had a head-start in the U.S., effectively edging out the other more contagious variants before they had a chance to take hold.

"What we have seen across the globe is that more easily transmissible variants will ... outcompete those variants that don't spread as easily," said Dr. John Brownstein, the chief innovation officer at Boston Children's Hospital and an ABC News contributor.

According to Brownstein, B.1.1.7 was able to spread quickly because it entered the country before immunization became widespread.

In terms of whether B.1.1.7 will outcompete other major variants, epidemiologist Dr. Emily Martin, of the University of Michigan, said, "It depends on which variant reaches a group of people first, for example B.1.1.7 was the first to start spreading in Michigan,"

Experts still aren't sure why some viral variants are more contagious than others.

One idea is that they can create a more significant viral load, meaning they can produce higher levels of virus in your nose, creating a greater opportunity for the virus to spread. It's also possible that these variants are better at latching onto or getting into cells, meaning someone exposed to the virus is more likely to become infected.

The good news, experts say, is that current vaccines and public health measures appear to be effective against B.1.1.7.

"We can develop vaccines that are closer to the variants, but it seems that so far we have effective vaccines," said Dr. Gigi Gronvall, an immunologist and associate professor of environmental health and engineering at Johns Hopkins University.

"There is nothing magical about these variants. All the things that everyone knows how to do -- wearing masks, good ventilation, distance, etc. -- all these things are still effective," Gronvall said. "It is a bit of a race with vaccination, because these variants are more transmissible, which is blunting the effect of the vaccination."

According to Brownstein, it's possible that in the years ahead, specialized booster shots may offer even better protection against any new variants that emerge in the future.

"As we let viruses evolve, there may be variants that can evade current vaccines, which is where boosters will be helpful," Brownstein said.

Scientists are already testing booster shots. But so far, all evidence indicates that currently available vaccines protect against the B.1.1.7 like they protect against the others.

"I think we should see a booster in the U.S. in the next 1-2 years, but this will all come down to hospitalization and mortality data," Brownstein said. "We don't know yet if the booster will be based on B.1.1.7 or another variant."

Karine Tawagi, M.D., a hematology and oncology fellow at Ochsner Medical Center in New Orleans, is a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.


In rare instances, South Africa variant may evade Pfizer vaccine, researchers say

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(NEW YORK) -- The first real-world study pitting COVID-19 variants against the Pfizer vaccine showed that the variant first detected in South Africa may be able to evade some vaccine protection, new research conducted in Israel found.

While "breakthrough" COVID-19 cases, meaning people who get infected or sick despite being vaccinated, are extremely rare, health experts have been monitoring a handful of virus variants to see if current vaccines offer robust protection against them.

The new study, which has not yet been published in a peer-reviewed journal, took place in Israel, which has fully vaccinated 57% of its population, according to Our World in Data, almost exclusively using the Pfizer vaccine. The research, which was conducted by Tel Aviv University and Clalit, Israel’s largest health care provider, and released on Sunday, analyzed data from roughly 400 people who had tested positive for COVID-19 after receiving at least one dose of the Pfizer vaccine. In the study, 149 participants tested positive at least one week after their second vaccine dose.

The B.1.1.7 variant first identified in the United Kingdom was the dominant strain detected during the study period, while the variant first detected in South Africa, B.1.351, made up less than 1% of cases.

The good news, experts said, is that the Pfizer vaccine appeared to work well against all the variants circulating in Israel. But the vaccine isn't 100% effective, meaning a small number of people became infected after getting their shots. These breakthrough infections were more likely with the South Africa B.1.351 variant.

Among people who received both doses of the vaccine, the prevalence of the B.1.351 variant was 5.4% in breakthrough cases compared to 0.7% in the unvaccinated population, meaning it was eight times more prevalent among the vaccinated study participants.

"Our study indicates that vaccine effectiveness is lower against the South African variant," Adi Stern, study author and professor at Tel-Aviv University's Shmunis School of Biomedicine and Cancer Research, told ABC News. Researchers couldn't pinpoint how much lower that effectiveness might be, but Stern said she did not believe the reduction to be dramatic.

"This variant remains very rare in Israel, where vaccination percentage is very high," she added.

For the B.1.1.7 variant first detected in the U.K., "vaccine effectiveness remains high" among the fully vaccinated, according to the study.

But experts say that for the small number of people who experience breakthrough infections, vaccines protect against severe illness.

"What we do know, when breakthrough infections do occur, they tend to occur with fewer symptoms," CDC director Rochelle Walensky said during a Monday press briefing.

Limitations of the study include its sample size, which was small because the South Africa variant is so rare in Israel. The study, which looked at infections in people who had been vaccinated rather than overall infection rates, was not designed to measure vaccine effectiveness against different variants.

"I don’t think this should worry us unduly," said Dr. Richard Lessells, an infectious disease expert researching the variant in South Africa. "These findings seem to provide some support to what we currently understand -- that while the neutralizing antibody response is still developing post-vaccination and has not yet reached peak, there is still a risk of infection."

If the B.1.351 variant is circulating in a given location, "infection at that time may be a bit more likely with B.1.351," Lessells added.

In the United States, the B.1.351 variant is rare, making up roughly 0.5% of cases, according to the Centers for Disease Control and Prevention.

Pfizer and Moderna have been testing boosters specifically targeted against B.1.351 and evidence suggests that the three vaccines authorized in the U.S. work equally well against the B.1.1.7 variant, which is now dominant in the U.S. People who do become sick after being fully vaccinated should still have partial protection, experts say. Instead of going to the hospital or dying, they may have less severe symptoms, like feeling run down or developing a slight fever.

A spokesperson for Pfizer pointed ABC News to the pharmaceutical company's clinical trial data from South Africa. On April 1, Pfizer released a press release stating that the vaccine was "100% effective in preventing COVID-19 cases in South Africa, where the B.1.351 lineage is prevalent."

In the small clinical trial in South Africa, which included 800 participants, nine tested positive for COVID-19, all of whom were in the placebo group and did not receive the Pfizer vaccine.

"Our results do indicate that there is some reason for concern, but definitely no reason for unnecessary alarm," Stern said. "It is always important to keep in mind that vaccine protection is never 100%," she added. "As long as case counts are high, even fully vaccinated individuals should take precautions."

ABC News' Sony Salzman, Eric Strauss and Brian Hartman contributed to this report.

 

Copyright © 2021, ABC Audio. All rights reserved.


US vaccinations are increasing, but what happened to COVID-19 testing?

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(NEW YORK) -- As more Americans get vaccinated, the urgency to get a COVID-19 test is steadily declining despite the Biden administration promising there would be a "wartime undertaking" to increase access, with billions of dollars in investment from U.S. manufacturing companies to develop new COVID-19 tests.

The U.S. has continued a downward trend, with a 30% decrease in the number of daily COVID-19 tests, according to the Johns Hopkins University Coronavirus Resource Center. The U.S. now conducts just over one million tests a day after hitting its peak for the year so far on Jan. 15 with 2.3 million tests.

With roughly 20% of the U.S. population fully vaccinated against the coronavirus according to the Centers for Disease Control and Prevention, the nation still remains months away from vaccine availability being widespread in all regions of the country.

"Even if you take the really optimistic view that we're not missing anything right now, I just worry that we've lost that infrastructure," said Dr. Jennifer Nuzzo, lead epidemiologist for the Johns Hopkins Coronavirus Resource Center. "If we suddenly need to surge testing again, it's not clear to me how we would do it given that a number of the testing sites have turned over and are focused on vaccines."

COVID-19 testing has been a highly politicized issue from the pandemic's onset, with the first set of tests rolling out slowly and often highlighting a racial disparity within the U.S. health care system's infrastructure.

But now with the focus almost entirely on vaccinations and more states gradually starting to lift coronavirus restrictions, some medical experts see an immediate challenge in reversing the testing downturn.

"My assessment of what's going on out there is that COVID fatigue has had its influence on testing. There is a sense generally in the community that the proverbial light is getting brighter every day," said Dr. William Shaffner, a professor of infectious diseases at Vanderbilt University Medical Center. "That notion is out there in abundance, contrary to public health concerns, but I think it has contributed to a reduction in testing, which is unfortunate."

Testing still remains the surest way to track new infections with a continued nationwide increase in COVID-19 cases, and new, more contagious viral strains complicating the federal pandemic response.

The CDC recently declared the B.1.1.7 coronavirus strain, otherwise known as the U.K. variant, as the most predominant viral strain in the nation.

"We now have variants out there. And we need to know where the residual areas of viral spread are," said Shaffner. "The only way you can find that is to determine where the new cases are -- and you determine where the new cases are by testing."

The idea of consistent coronavirus testing as the U.S. vaccination rate increases seems to resonate more with the leaders of universities, school districts, private sector organizations and government agencies. Such organizations are rolling out spring pilot programs to explore how they might return students and employees to their buildings in greater numbers this fall.

The U.S. Food and Drug Administration partnered with Labcorp in March to implement a voluntary COVID-19 testing program for agency employees and contractors doing in-person work at government buildings or elsewhere.

Approximately 3,000 polymerase chain reaction, or PCR, tests a month are expected to be provided to FDA employees over the course of the program's year-long contract. Some FDA personnel inspect vaccine manufacturing facilities and food work places, making coronavirus testing a critical component of the agency's return to work.

The test -- the Pixel by Labcorp -- is designed for users taking a swab of their nostril and then sticking it into a solution. Users can expect test results within 48 hours after the lab processes that sample.

"This is adding one more way for them to access the test, it doesn't replace other opportunities to get tested where appropriate," said Dr. Brian Caverney, chief medical officer at Labcorp and president of Labcorp Diagnostics. "We don't have any idea how many of the tests will actually be used. It's just one of many purposes."

As U.S. companies and business grapple with how to implement effective testing regimes, the U.K. is taking their plan for rapid testing a step further, offering it to each of their citizens, at least twice a week.

In the U.S., the Biden administration laid out a $50 billion plan that would boost the nation's testing capacity through the increase of rapid antigen tests, testing centers, expand lab-test processing, provide uniform guidance for in-school COVID testing and establish a national pandemic testing board.

Ten billion dollars was allocated for testing in schools from the recently passed stimulus package aimed at helping districts confront the task of getting more children back into the classroom safely.

The administration also announced a $230 million deal with Ellume, an Australian digital diagnostics company, to provide 8.5 million over-the-counter at-home tests. Ellume plans to produce 100,000 testing kits per month through July and ramp up to 19 million a month by the end of the year.

But despite the federal investment in testing and retail stores purchasing millions of rapid tests in bulk from U.S. test manufacturing companies, those efforts still haven't paid off with higher daily COVID testing numbers.

A Biden administration official, who spoke on condition of anonymity, told ABC News there has been no reduction in urgency regarding federal and state testing programs aimed at providing Americans greater access to COVID-19 testing.

The official also said the goal is now to ensure that Americans are aware and can easily access the various testing options available to them.

But still, some doctors and health care workers struggle to see how the Biden administration's ambitious plans for testing is meeting its promise with daily test numbers down.

"I haven't yet seen it realized on the ground, in the field," said Schaffner. "But any kind of structure and support one can give toward testing to stabilize that and to have people working in testing programs that are commuted over time is important so this is not a one-shot deal."

Copyright © 2021, ABC Audio. All rights reserved.


Postpartum nurse and mom shares her top tips for new parents

ABC News

(NEW YORK) -- Bringing home a bundle of joy isn't always a walk in the park, but one nurse and soon-to-be mom of four, Karrie Locher, is making it easy for moms about to welcome their newborns.

Last Spring, Locher, who is a registered nurse, launched her Instagram to help families transition from hospital to home.

On her Instagram, she shares advice based on her professional and personal experience -- from tips on breastfeeding to changing a baby's diaper to bath time, the 29-year-old is shedding light on postpartum so new parents don't have to go through the process alone.

"When I had my own child and went home, I was like, 'Wait, nobody told me about this, nobody told me about that,'" Locher told ABC News' Good Morning America. "I found ... that there was such a big lack of education for parents going home and of what to expect. I feel like there's this highlight reel of what you see it's going to be like and then when it's not that way, it can feel very guilt-inducing for new moms."

Amid the coronavirus pandemic, Locher said she also noticed that a lot of hospital classes that teach new parents these postpartum lessons are no longer being held.

So, Locher started her Instagram to help parents get the information they need. And in just one year, the 29-year-old has created a loyal audience of over 230,000 followers including Marisol Mena, who is set to welcome her baby girl, Olive, next month.

Locher personally helped Mena with a basic course on what to expect once her baby girl is home from the hospital.

Read on for some of Locher's top tips:

Make bath time an easy, two-step process

Locher says many parents aren't aware that newborns can only have sponge baths for the first couple of weeks.

"You can't actually submerge your baby's abdominal area in water because that umbilical stump is in place for the first couple of weeks," said Locher. "We're really not supposed to get that area wet because the whole purpose is for it to dry up and fall off on its own."

So, Locher suggests a sponge bath done in a two-step process, on something as simple as your baby's changing mat. First, Locher says to focus on the baby's body. Have a warm basin of water nearby and a washcloth with shampoo.

Once you get your baby all cleaned up, Locher suggests parents dry them off and put them in a fresh diaper and new pajamas. Then, Locher says to swaddle your baby so that you have control of your baby's head while you can wash their hair.

"She can be looking at you and enjoying herself, and that's what makes bath time so fun in those early weeks, especially because you want to bond, too," added Locher. "You want to have fun with the bath. It's not just like a chore, you know?"

For when tummy troubles strike

One of the toughest things Locher says new parents struggle with is helping their newborns deal with gas.

"We don't really touch on it much with discharge instructions," said Locher. "You get home and you're like, OK, what can I do to help my baby? She's struggling, she needs to pass gas -- she might be a little bit more fussy… it's heartbreaking as a parent."

To help your baby, Locher recommends an "I love you" abdominal massage to relieve gas.

"What I found the most effective was actually infant tummy massage and just massaging her belly after a bath," she said. "It helped so much."

Locher said with your fingertips, draw an "I," an "L'' and a "U" on your baby's left side of their abdomen.

"You just go downward to make the 'I' and then you start on the other side, the right side of their abdomen, go across and down to make that 'L,' and then you just do a nice big arch to make the 'U' at the end," said Locher. "You always want to be moving in a clockwise position because that's the way the baby's gut moves."

Create a nursing cart

To help make things convenient as a new mom, Locher suggests creating a nursing cart filled with mom and baby essentials like snacks, water and diapers.

"I always found myself like running to get more things," said Locher. "I'm like, 'Why don't I just have something on wheels that I can just take with me?' It's so much more convenient."

Other things that Locher says she puts in her nursing cart are nail files and extra rags.

Copyright © 2021, ABC Audio. All rights reserved.


Lost taste and smell from COVID-19? A new cookbook aims to help

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(NEW YORK) — One of the most common COVID-19 symptoms is the loss of taste and smell. For some people, those symptoms can last weeks. Now, a new cookbook aims to help people recover some of the joy of cooking and eating – even while senses are still inhibited.

The cookbook, "Taste & Flavour," was written by chefs Ryan Riley and Kimberley Duke. It blends aspects of culinary science and medical research by looking at taste, smell and other sensory perception to help people who lost their senses enjoy food again.

Some estimates show that loss of smell from COVID-19 typically lasts two to three weeks for roughly more than half of patients who test positive for the virus. According to one study from Dr. Piccirillo from the Department of Otolaryngology at Washington University School of Medicine in St. Louis, 95% of people who experience these problems recover completely.

While the science surrounding the changes in taste and smell from COVID-19 is still evolving, researchers have noted that for some patients when they do regain smell, fragrances they used to enjoy smell different, even unpleasant to them. This could be due to olfactory cells having to “rewire” as they recover.

According to Dr. Barry Smith, a scientist who worked on the cookbook, it’s possible to use food therapeutically.

While the recipes in the book won’t cure the loss of taste and smell, they can help people still find enjoyment in eating while these senses recover on their own.

Many people who experience these symptoms are still able to taste certain flavors such as sugar, salt, lemon juice or even the bitterness of coffee, according to Smith. He said his work showed that when taste and smell are altered, other senses can help people enjoy their food with certain textures. These can include stimulating saliva with umami flavor and stimulating the trigeminal nerve, which amongst other roles, regulates spicy-food sensations like stinging, cooling or even burning.

Riley provided an example of these principles with one of his favorite dishes from the book, miso butter potatoes with green herb vinegar. Miso and potatoes both have a strong umami flavor, which has been helpful for those struggling with changes in taste because of how well they elicit saliva. Smell, which he explained accounts for 80% of taste, is also satisfied via the vinegar, pepper and mint found in this dish. Mint, for example, stimulates the trigeminal nerve.

Meanwhile, the chefs said that garlic and onion, which normally are excellent bases for many dishes, are often found to be repulsive to patients suffering from altered taste and smell.

“It was all about having to create what's called safe, non-triggering foods. We know things like potatoes are really good for that, pasta rice, quite simple flavors," Riley told ABC News. "So then we then use the life kitchen principles, looking at using a lot of umami, which is our fifth taste or soy sauce, mushrooms, parmesan, and trying to add in all of that as the depth and the base that you would originally get from things like garlic and onions to create delicious tasting food.”

For people experiencing these symptoms, it’s not just about food. Studies show losing these senses or having them altered in some way is linked with depression and other mood symptoms.

“We saw that people were really struggling," Duke told ABC News. "They felt like they didn't have anyone who was helping them and, and they didn't feel like their partners and families understood what they were going through.”

“There's also a huge mental health aspect of this," Riley said. "We know from cancer that once you start not enjoying food, you don't eat as much, which is detrimental to the body. If you don't taste something for eight months, it can become really depressing."

And there are other risks. Lack of smell can also put people at risk for fires and food poisoning as they lack the ability to smell spoiled food or even smoke.

Duke and Riley embarked on this research prior to the pandemic to help cancer patients, who may also suffer from a loss of taste and smell because of the effects of chemotherapy.

"Both me and Kimberly lost our mothers to cancer when she was 15, and I was 20. And I wanted to become a food writer and a chef," Riley said. They founded a non-profit, Life Kitchen. Last year, their cookbook became the number four bestselling book in the UK.

For COVID-19 recovered patients, experts said more research is needed into exactly how some senses are processed in the brain before further treatments can be perfected.

But for now, Riley and Duke are hoping a few thoughtful recipes might bring some relief.

The cookbook can be downloaded for free.

Samuel Rothman, MD, is a psychiatry resident at the BronxCare Health System in New York City and a contributor to ABC's Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.


What to know about expected but rare 'breakthrough' COVID cases

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(NEW YORK) -- With one in four adults in the United States now fully vaccinated against COVID-19, health departments and scientific studies have documented what's known as "breakthrough" cases, or people who got infected or sick despite being vaccinated.

Such instances are exceptionally rare, but expected, experts say.

"You will see breakthrough infections in any vaccination when you're vaccinating literally tens and tens and tens of millions of people," Dr. Anthony Fauci said during a White House press briefing on March 26. "In some respects, that's not surprising," Fauci said.

COVID-19 vaccines are highly effective -- but none are 100% effective, meaning a small number of people might become infected after being fully vaccinated -- but those infections are typically mild, or symptom-free.

Dr. William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, called the roughly 95% efficacy rates for the Pfizer and Moderna vaccines "spectacularly effective." In clinical trials, the vaccines were virtually 100% effective at keeping people out of the hospital, he added, noting that "there were still some milder infections that took place."

How common are COVID-19 'breakthrough' cases?

"It's pretty darn rare," Dr. Shira Abeles, an infectious disease specialist at UC San Diego Health, said of breakthrough cases. "I think it'll remain that way," she added.

Recent real-world studies have confirmed that low breakthrough rate. Research that Abeles helped conduct in Southern California between December 2020 and February 2021, found that less than 1% of the 36,600 health care workers who were studied tested positive for COVID-19 after being fully vaccinated, meaning both doses plus two weeks for the immunity to build -- with the Pfizer or Moderna vaccines.

Not a single vaccinated health care worker who contracted COVID-19 was hospitalized or died and those who did get sick appeared to have milder symptoms than the unvaccinated, according to the researchers.

An even bigger investigation conducted by the health department in Washington state found that of 1.2 million fully vaccinated people, there was evidence of 102 breakthrough cases, representing less than 0.01% of fully vaccinated state residents. While most of those patients experienced mild symptoms, at least eight were hospitalized and the health department is investigating two potential breakthrough cases where the patients died.

How do COVID-19 'breakthroughs' happen?

It's not completely clear.

People who are very old or immunocompromised may be at higher risk for breakthrough cases, because their bodies might produce a less powerful immune response to the vaccine.

"For every vaccine that we use, immunocompromised people and the very old don't respond as well as healthy people and younger people," Schaffner said. In the case of the Washington state investigation into the two potential breakthrough COVID deaths, both patients were older than 80 years old and had underlying health issues.

Similar to the flu, the higher risk for older and immunocompromised people is one reason it's important for young, healthy people to get the COVID-19 vaccine. If everyone's vaccinated, it's harder for the virus to find targets, which protects those at higher risk.

"We should all get vaccinated to protect ourselves as well as to protect the weaker among us," Schaffner.

As for breakthrough cases among young or healthy people, "every once in a while, something happens for biological reasons we can't quite explain," Schaffner said.

Those who do become sick after being fully vaccinated should still have partial protection. Instead of going to the hospital or dying, they may have less severe symptoms, like feeling run down or developing a slight fever. "That's the strength of our study," Abeles noted. "We were doing screening in a population, so we were picking up asymptomatic disease and mild illness," she said. "That's generally what you're going to see."

Another possibility that public health officials are investigating is whether new variants of the virus caused some of the reported breakthrough cases.

"One of the important things that will be done and must be done is to sequence the genome of the virus that's the breakthrough virus," Fauci said. "It would be very important to see if they broke through with the wild-type virus, which would indicate a real diminution of immunity, or whether it broke through with one of the variants, which would be much more explainable if you don't have enough cross-reactivity."

So far, it seems that the currently authorized vaccines diminish the severity of infection regardless of the virus strain. This is why experts say it is of utmost importance for even people previously infected with COVID to get vaccinated. Knowing whether breakthrough cases were caused by the virus the vaccines were designed to protect against or by new variants could inform scientists how to approach future vaccinations and booster shots. If a variant of concern is breaking through, scientists in the lab might develop a vaccine targeting the variant's spike protein mutations, Abeles explained. If the virus is one that the community has already been exposed to, and it appears immunity is waning, health experts might suggest a booster of the same vaccine, she added.

"It's a moving target and we're still learning so much," Abeles said. "We'll be paying close attention."

In the meantime, it's crucial to keep infection levels low so that there's less evolutionary pressure on the virus to mutate into more variants of concern. "We want to keep them at just a few, rather than let the virus have too many opportunities," Abeles said.

Copyright © 2021, ABC Audio. All rights reserved.


Baby heads home after nearly 700 days in hospital

Francesca Garnetti

(ANN ARBOR, Mich.) -- A Michigan baby is now home with her family after a hospital stay that lasted 694 days.

Valentina Garnetti was diagnosed in utero with hypoplastic left heart syndrome -- a condition that affects normal blood flow through the heart and causes the left side of the heart to not form correctly. The 1-year-old remained in

"She's the happiest baby in the whole entire world, despite everything's she's been through," mom Francesca Garnetti told Good Morning America. "She's the greatest joy. She loves everyone ... she just loves her life, genuinely."

Valentina was born at Mott Children's Hospital and stayed in its pediatric cardiothoracic intensive care unit.

Valentina has had six surgeries, including four open-heart surgeries and was once placed on life support for 14 days. Her first open-heart surgery came when she was 2 days old, and her most recent was in October.

"It's terrifying, I don't think you can prepare yourself for something like that," Garnetti said.

During her stay, Valentina became close with her six primary nurses: Erin, Wendy, Denise, Amanda, Stephanie and Liana. Garnetti even named Liana as Valentina's godmother.

"I've relied on my faith a lot and she helped me through it," Garnetti said of Liana. "On a personal level, if anything were to happen to me, she loves Valentina. She knows how to care for her and she would, without a doubt."

Dr. Mary Olive is a pediatric cardiologist at Mott Children’s Hospital who worked with Valentina.

"Valentina had a long and difficult journey here at Mott, but she continued to surprise us with her strength and resilience," Olive told GMA. "It was inspiring to see our whole congenital heart center team come together to determine how to best care for her."

"Her mom was also very strong and dedicated to doing whatever it took to help her get home," Olive added. "We were just so happy to see Valentina get to go home and spend time with her siblings and family."

On March 24, the hospital had a celebratory sendoff for Valentina.

Valentina is now home with her sisters, Gianna, 5, and Adriana, 1. Garnetti said Valentina is happy to finally be playing with other children.

Garnetti is now connecting with parents of kids who have heart conditions through the Facebook page, Valentina's Journey.

Copyright © 2021, ABC Audio. All rights reserved.


A next-gen Army COVID vaccine you've never heard of has just begun human trials

Matt Seyler/ABC News

(SILVER SPRING, Md.) -- As more than 100 million Americans were needled and inoculated against COVID-19 with doses produced by pharmaceutical powerhouses like Pfizer and Moderna, a scrappy team of scientists in an Army lab just outside the nation's capital quietly continued manipulating proteins, testing monkeys and working to conceive a vaccine of the future.

The product born of their experience, reason and labor was injected into its first human test subject on Tuesday.

"We want to win this battle, but we also want to win the long war," said Dr. Kayvon Modjarrad, who leads the vaccine effort as director of the emerging infectious diseases branch of the Walter Reed Army Institute of Research (WRAIR) in Silver Spring, Maryland.

Once the virus was sequenced in January 2020, he and his then modest team of 10 strategized and took on a blistering 24/7 effort, whittling a selection of two dozen prototypes down to a single vaccine candidate within six months.

Over the last decade Modjarrad also led the Army's vaccine efforts for Ebola and the Zika virus and was principal investigator of its campaign against MERS, a disease itself caused by a coronavirus. And though WRAIR is the oldest biomedical research institute within the Department of Defense, the emerging infectious diseases branch is still young.

"We're not Apple now -- we're Apple 40 years ago, in the garage," Modjarrad said with a laugh.

Despite the frantic pace, Modjarrad -- who co-invented @BobWoodruff reports on a vaccine candidate being developed by military scientists at Walter Reed, and what makes this vaccine a potential weapon against variants and future pandemics. https://t.co/89rGo4QEuG pic.twitter.com/WA09ftz97M

— ABC News Live (@ABCNewsLive) April 8, 2021 ">WRAIR's eventual vaccine candidate -- knew it wouldn't be the first to the public.

"This one takes a little bit longer in designing and then manufacturing," he said.

From the beginning his focus was on next-generation threats, ones that could be thriving in unknown bat caves as you read this sentence, waiting to make contact and proliferate inside humans.

"Even though we got the (available vaccines) within a year, how many hundreds of thousands of people in the U.S. and how many millions of people globally lost their lives before the vaccine was even available?" Modjarrad asked ABC News' Bob Woodruff during an exclusive visit to the lab last week. "We want to get to a point where the vaccine is already out there -- maybe already in people's arms -- before the next variant, next stream, next species of coronavirus occurs."

The three vaccines already authorized for use in the U.S. work by feeding the body genetic instructions to create the spike protein that is found on the surface of the virus. Once the body creates the protein, the immune system is alerted and begins forming antibodies. It's a safe way of triggering a similar immune response as one a person would have after contracting the actual virus.

The WRAIR vaccine skips both the instruction and creation steps, bringing the already-formed spike protein straight into the arm along with an immune-boosting adjuvant compound, quickly starting the antibody response.

And unlike other protein-based vaccines being tested, the WRAIR candidate presents virus-looking nanoparticles, each with a consistent array of 24 spike proteins arranged in small bouquets of three protruding from a ferritin base.

"There's a lot of theories as to why something presented in this fashion gives such a good immune response, but in some ways you can see it looks like a virus as well," Modjarrad said. "So it has some properties that educate the immune response in a way that it gives you a very strong, but also a broad response."

Test results with thousands of mice and dozens of monkeys have been promising.

"We think (other) vaccines are probably going to be protective against new variants, but they might be decreased in their protection," Modjarrad said. "What we've seen with our vaccine so far in animals ... is that the vaccine is not decreased in effectiveness against those variants at all. And it is effective against other coronaviruses like SARS-1. So what we have developed now is starting to look like a pan-SARS vaccine ... and we're going to start testing everything in between."

If successful in clinical trials, WRAIR's vaccine could become common among the U.S. population, possibly as a booster for already-vaccinated people.

Being a military lab, practicality was a primary design concern, which could incidentally give their product global appeal. In particular, it is highly stable and doesn't require special freezing.

"That means you can put it in a cooler on the back of a motorcycle in the Amazon or the Sahara or wherever, and that vaccine should still be OK," Modjarrad said.

But the "if" remains. Though the WRAIR scientists brim with confidence in conversation, they are soberly aware that their product has yet to be proven in humans.

"They have some very early data to suggest in the laboratory that the immune response evoked by this vaccine will cover a variety of different strains," said Dr. William Schaffner, a professor of preventative medicine and infectious diseases at Vanderbilt University in Nashville. "Whether that translates actually into protection in people against the variety of strains -- that remains to be determined. Long journeys, first steps."

On Tuesday, retired Army Col. Francis Holinaty stepped up to be the first to be injected in WRAIR's Phase 1 trial.

"Over my 30-year career I have served in many places around the world in many different operational settings, some more arduous than others, some more hazardous than others," Holinaty said. "And one day I'm on the Metro, and it's almost as if it was fate -- I just looked up and I saw a poster, and I saw Walter Reed, and it took me a while to process what this poster was saying. And when it dawned on me that they were trying to do a trial for the COVID-19, I saw this as another opportunity to just serve."

Holinaty can't be sure whether he received a dose of the vaccine or a placebo, but said afterward that he felt fine. He wanted people to know that there are many ways to fight the pandemic.

"You don't have to be in the military, you don't have to be a first responder, but you can help all," he said. "And if you have a calling to help people this is just one of the ways you can do it."

Copyright © 2021, ABC Audio. All rights reserved.


COVID-19 origins: What to know about the search for the start of the virus

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(NEW YORK) -- More than a year after a "mysterious pneumonia" sickened workers at a seafood market in China, scientists are still gathering clues about where SARS-CoV-2 -- the virus that causes COVID-19 -- emerged from.

"It's critical to understand where this virus came from, so that we can understand how to stop future outbreaks going forward," said Anne Rimoin, an infectious disease epidemiologist at UCLA.

The investigation into the virus' origins is crucial for public health and science reasons, but it has also sparked tension among world powers, especially between the United States and China, whose leaders have accused one another of lack of transparency and xenophobia during the pandemic.

"It's not about finger-pointing -- it's just about understanding it, so we know how to do better in the future," Rimoin said.

To that end, on Jan. 14, 2021, the World Health Organization deployed a group of 17 international experts to Wuhan to work with Chinese scientists on an in-depth investigation into the virus' origins.

Scientists have long said that SARS-CoV-2 has zoonotic origins, meaning that it likely jumped from animals to people when humans came in contact with an animal infected with the virus. That contact could include handling the infected animal, eating it or preparing the animal for market, according to Rimoin.

However, experts didn't know exactly how the virus had gotten into people and reaching a definitive conclusion about SARS-CoV-2's origins might take years. They also don't know where or when the virus first made its way into humans and several studies suggest that it may have been present elsewhere in the world -- perhaps circulating at low levels -- before the major outbreak in Wuhan, China.

"You're trying to reconstruct events from a year and a half ago with incomplete sampling and data," Dr. W. Ian Lipkin, director of Columbia University’s Center for Infection and Immunity, told ABC News. "We may never know exactly what happened."

If previous infectious disease investigations are any clue, the virus' origins could remain shrouded in mystery. The best comparison is the 2003 SARS outbreak, which was caused by a close cousin of the virus that causes COVID-19 and eventually traced back to a single population of horseshoe crab bats.

But that search took more than five years. "I think they were quite lucky," Vincent Racaniello, a microbiology and immunology professor at Columbia University's College of Physicians and Surgeons, said of the SARS investigation. "We've still not found the source of Ebola virus outbreaks after many years of looking," he added. "It's not easy."

The joint WHO-China report is considered a first step in what will likely be a years-long investigation released its findings last week. But the report itself has been mired in controversy. Following its release, the United States and 13 other countries raised concerns about the report in a joint statement, arguing that the international investigation was "significantly delayed and lacked access to complete, original data and samples."

But many experts say the report, though imperfect, is an important first step.

The investigators explored four major theories of how the virus spilled over into humans, ranking those ranked those theories in order of likelihood, from "very likely" to "extremely unlikely."

The intermediary host theory: This theory proposes that the virus was transmitted from an original animal host to an intermediate host, such as a minks, pangolins, rabbits, raccoon dogs, domesticated cats, civets or ferret badgers, and then directly infected humans through live contact with the second animal.

WHO-China investigation conclusion: "likely to very likely"

The zoonotic spillover theory: The zoonotic spillover theory suggests that SARS-CoV-2 was passed directly from an animal, most likely a bat, to humans. This transmission could have happened through farming, hunting or other close contact between humans and animals.

WHO-China investigation conclusion: "possible to likely"

The frozen food chain theory: The "cold-chain" theory suggests that transmission of SARS-CoV-2 from animals to humans might have happened through contaminated frozen food. A frozen food product contaminated with animal waste that contained SARS-CoV-2 could have transferred the virus to humans without any direct live contact between humans and animals.

WHO-China investigation conclusion: "possible"

As part of the investigation, scientists returned to the Huanan seafood market associated with the first known cluster of cases in Wuhan. They also visited the Hubei Provincial Hospital of Integrated Chinese and Western Medicine, where some of the first COVID-19 cases were treated, and looked at viral sequencing data. That viral sequencing showed that different minor variants of SARS-CoV-2 were spreading in Wuhan in December 2020.

"That again suggests that maybe the virus had been circulating a little bit longer than people had realized," said Dominic Dwyer, an epidemiologist and member of the WHO investigative team.

Viral sequencing also showed that the Huanan market likely wasn't the primary source of the outbreak. While many early cases were connected to the market, a similar number of cases were associated with other markets, or no markets at all, the WHO-China report found.

"The market was certainly an amplifier, but probably not the actual source of the whole outbreak," Dwyer said.

One of the last places the investigators visited was the Wuhan Institute of Virology, the target of a politically charged theory that the virus had accidentally leaked from a lab. The report cited high biosafety levels at labs in Wuhan, no evidence of respiratory illness in workers and no storage or lab activities on coronaviruses or bat viruses.

Prior genomic sequencing showed that the virus had natural origins and the WHO-China team ranked the lab leak theory as "extremely unlikely."

But Dr. Tedros Adhanom Ghebreyesus, the WHO's director-general, said that he didn't think the team's assessment of the theory was extensive enough.

Further data and studies will be needed to reach more robust conclusions, Tedros said at a press conference about the report's findings, noting that he was ready to deploy additional missions with specialist experts to do so.

"Science can't rule things out like that," Peter Daszak, a zoologist and member of the WHO investigative team, said of the lab leak theory. "You can only really show positive findings, you can't prove a negative. But what we did find is that the lab escape was extremely unlikely."

The most likely pathway, the report found, was the first theory, that the virus passed from a bat to an intermediary animal and then to humans. According to Daszak, next steps for investigation could include tracing back the first cases of the virus; investigating market suppliers for unusual spikes in antibodies; and examining locations with concentrations of animals we know are susceptible to SARS-CoV-2.

Rimoin hopes the pandemic has shown that disease surveillance is key to preventing future outbreaks, not just reacting to them. As population growth and climate change push humans further into animal habitats, "we will see more viruses jumping from animals to humans and we're going to see more disease emergence events," Rimoin said.

"An infection anywhere is potentially an infection everywhere," she said.

Copyright © 2021, ABC Audio. All rights reserved.


With obesity on the rise, the best diet may be tailored to our genes, experts say

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(NEW YORK) -- With the COVID-19 pandemic drawing more attention to America's obesity problem, a growing body of research indicates that our genetics should be used to determine what we eat.

Decades of research shows that, at least for most people, the secret to staving off disease is getting plenty of exercise and eating diet high in vegetables and with a healthy mix of fats, protein and carbs. But now a budding field called "nutrigenomics" aims to offer people personalized lifestyle advice based on each person's DNA.

Though still a new area of scientific study, researchers hope food plans based on genetic makeups will be more effective than traditional one-size-fits-all recommendations.

"Given the greater concern for high blood pressure, high blood sugar and obesity, and their association with severe COVID-19, I foresee a great emphasis on personalized nutrition, with the use of data from genetic tests and monitoring blood glucose, to help people make positive choices and decrease their risk," said Brigid Titgemeier, a functional medicine dietitian and founder of beingbrigid.com.

Decades after the Human Genome Project mapped the genes of humans, scientists now are using this information to better understand how food can modify predispositions to disease and immune functions.

Nutrigenomics is described as a genetic approach to personalized nutrition, including not just diet but sleep patterns and one's overall lifestyle.

"It embraces this idea that despite all of us being 99.9% the same, there is that 0.1% that truly determines how you respond to the world around you," said Dr. Yael Joffe, founder and chief science officer of 3X4 Genetics.

"Following a diet that is restrictive or one seen on social media may result in some improvement, but they aren't sustainable and aren't data driven," said Dr. Marvin Singh, an integrative gastroenterologist and founder of Precisione Clinic. "Nutrigenomics provides an understanding of your predispositions and deficiencies. In terms of weight loss, it can provide data on particular gene mutations you have that might favor you acting or eating a certain way -- or even exercise patterns that may be more helpful."

Accessing one's genetic makeup can be done with saliva sampled from a cheek swab and sent to a lab. Using the data a subject gets back, Joffe said, can help inform that individual which foods can be eaten to turn on or off certain genes.

"We are all going to respond a bit differently when we eat a salad," said Kristin Kirkpatrick, a nutritionist and the president of KAK Nutrition consulting, "since there is no diet that is one-size-fits-all. We need to look at our DNA if we want to lose weight."

Diet and exercise is the first recommended treatment for the majority of the chronic diseases in the U.S. -- hypertension, obesity, diabetes and high cholesterol. But personalized nutrition based on genetics, research has shown, is more effective in reaching long-term weight-loss goals.

"Genetics is an extremely powerful behavioral tool to implement long-standing changes," Joffe added. "It's about you. It's your story. Not something you read on social media or the internet."

In his clinic, Singh finds that patients are more likely to stick to treatment plans tailored to their own genetics, so having access to that data helps him provide a framework for better treatments.

"A low-salt diet is recommended if someone has high blood pressure," Singh said, "but everyone's blood pressure may not respond to this. Using genetic information, I can see if a person's blood pressure would respond favorably to this dietary change and if there is something else that is driving their disease."

By changing variables such as sleep patterns, diet and exercise, it is ultimately difficult to measure the impact of a genetic test, explained Joffe.

Nutrigenomics is new and constantly evolving, and experts told ABC News there's much left to learn.

"More research needs to be done so we can have even more specific dietary guidance," Titgemeier said. "Right now, certain mutations in our genes can tell us to have a diet low in saturated fat, however, what we don't know is the percentage."

Health care consumers also need to be careful their genetic information doesn't end up in the wrong hands -- some companies have been found to collect and sell data to third parties. One of the best ways to avoid being scammed? Talk to your doctor.

"The best way to start is with your primary care [physician] and asking if they know someone who does nutrigenomics or if they can get some information on this," Kirkpatrick said.

Eventually, experts said, using food as medicine may help reduce the risk of other serious diseases such as Alzheimer's dementia or heart disease.

"It's not the supplements or the food that we eat, it's what the food does to our body to make it heal itself," Joffe said. "This area of gene expression is really the extraordinary power of where nutrition lies."

Copyright © 2021, ABC Audio. All rights reserved.


CDC Director expects all schools will be fully open for in-person learning in September

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(NEW YORK) -- Centers for Disease Control and Prevention Director Dr. Rochelle Walensky anticipates that all schools will be fully in person and no longer remote in September 2021.

"We should anticipate, come September 2021, that schools should be full-fledged in person and all of our children back in the classroom," the CDC director told ABC News Chief Medical Correspondent Dr. Jennifer Ashton during an Instagram Live conversation on ABC News.

She said that parents and teachers should anticipate this regardless of whether children are vaccinated or not. "We can vaccinate teachers, we can test, there's so much we can do," she said.

Asked when she expects children will become eligible to get vaccinated, Walensky said by mid-May. Pfizer recently released promising data indicating its vaccine is safe and effective for children ages 12 to 15.

"Mid-May maybe we'll be able to have a vaccine from Pfizer that we'll be able to do down to 12," she said, pending Food and Drug Administration authorization for that age group.

She expects Moderna will soon follow Pfizer because those studies are currently underway. She said she is hopeful that by summertime there will be two vaccines available for children 12 and up. Johnson and Johnson Is expected to start their pediatric trials in the months ahead.

Walensky doesn't anticipate the vaccine will be authorized for children younger than 12 before the end of the year.

Walensky's comments came shortly after she said during a White House briefing that the more contagious variant of coronavirus that originated in the U.K., the B.1.1.7 variant, has become the dominant strain in the U.S.

All three vaccines authorized in the U.S. -- Pfizer, Moderna and Johnson & Johnson -- are believed to work well even against the U.K. variant.

Walensky stressed that the multiple COVID variants are serving to reinforce her goal of wanting a large portion of the U.S. population to get vaccinated.

"My goal is to have people want to roll up their sleeves and get vaccinated," she said.

Watch the full interview here.

Asked if she agrees that 85% is the percentage of the population that should be vaccinated, in agreement with Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, Walensky declined to put a number on it. She said estimates on the right percentage for herd immunity vary dramatically.

"[It] depends on how transmissible the virus is, and that we estimate that number based on the transmissibility. ... What we know is that transmissibility is actually a little bit of a moving target, because with more variants, some of these variants are more transmissible. So the more transmissible the variant, the more likely we're going to need a larger proportion of the population vaccinated," she said.
UK variant has become most dominant COVID strain in US, CDC says

On Wednesday, the CDC reported a seven-day average of 62,000 cases a day.

During a White House briefing last week, Walensky urged caution amid fears of a fourth wave. Then days later, the CDC updated its guidance on travel for fully vaccinated people. The guidance said that fully vaccinated people can travel within the U.S. without COVID-19 testing or quarantines as long as they continue to take precautions like wearing a mask, socially distancing and washing their hands.

Asked about the "confusing" messaging by Ashton, Walensky said, "sometimes the messages are complex" and that people working in public health aren't treating individuals, they are treating the population.

"We need to be able to offer people who are vaccinated things that they are able to do if we want people to come forward and get vaccinated: visit with their loved ones, visit their grandchildren, perhaps travel on a plane at lower risk. That's an individual message," she said. "While we have fully vaccinated 19% of the population, 80% of the population remains unvaccinated and that is certainly enough to cause a surge. And so on a population level, we still very much need to practice good public health measures -- masking mitigation, distancing."

She still stood behind President Joe Biden's comments that the Fourth of July holiday will look a little more normal.

"I would say still practice the mitigation strategies, still mask, still distance, try and keep the crowds to a minimum," Walensky said. "Because I really do think that when we get most of this country vaccinated, we can get back to a healthier, more normal evening at the baseball field."

Copyright © 2021, ABC Audio. All rights reserved.


Reproductive life span of women increasing, study shows

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(NEW YORK) -- The reproductive years for women in the United States may be increasing, according to a new study.

On average, the reproductive years for women increased from age 35 to 37.1, according to the study published Wednesday in the Journal of the American Medical Association.

The age of 35 has for decades been regarded in the medical community as the age when women's reproductive systems slow down and it becomes more difficult to have and sustain a pregnancy. Women who become pregnant at age 35 and above are considered of advanced maternal age and face risks including miscarriage, genetic abnormalities, fetal growth issues, preterm birth, preeclampsia and stillbirth, experts say.

Giving birth later in life is a growing reality in the U.S. though. Since 2007, the birth rate has risen 19% for women in their early 40s, 11% for women in their late 30s and just 2% for women in their early 30s. Birth rates for women in their 20s declined from 2015 to 2016, according to the Centers for Disease Control and Prevention.

The new study that found women's reproductive span now extends to 37 years of reproductive years, on average, looked at 60-year trends in age at natural menopause and reproductive life span and other factors among U.S. women. This increase in reproductive years may be a result of later ages of menopause and earlier ages of first period, on average.

The data showed that average age of menopause for women increased, from 48.4 years to 49.9. And the age that a girl got her first period dropped slightly, on average, from 13.5 years to 12.7.

"These are important numbers," said Dr. Jennifer Ashton, ABC News chief medical correspondent and a board-certified OBGYN. "It's good to get a grip on what's happening over a woman's reproductive life."

The changes in women's reproductive life spans could have potential implications for cases of both heart disease and cancer in women, according to Ashton.

She said the broadening of the life span could mean a slight decrease in cardiovascular disease among women, but could raise the risk of breast cancer, ovarian cancer and endometrial cancer, also known as hormonally responsive cancers.

"The more hormonal stimulation [there is] across a woman's lifetime, those cancers can go up," explained Ashton.

The milestone reproductive moments in women's life spans also come with side effects, which range from mild to severe, according to Ashton.

The side effects can range from fatigue and cramping on the mild end to mood changes, severe pelvic pain and heavy bleeding on the more severe end, according to Ashton. Women may also experience irregular menstrual cycles, changes in sleep patterns, and hot flashes in the years leading up to menopause, which is when women stop having menstrual periods.

"We have to remember these milestones in life, while natural, can be problematic," she said. "There's a range of symptoms."

Copyright © 2021, ABC Audio. All rights reserved.


NY hospital launches COVID-19 saliva testing for those seeking to attend large events, fly internationally

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(NEW YORK) -- Mount Sinai Hospital in New York is launching a COVID-19 saliva-testing program that could prove to be a game-changer for reopening large-scale events.

The program was unveiled Monday and will offer "easy, effective and accurate COVID-19 test for the public" at four testing locations in Manhattan, according to Dr. David Reich, the hospital's president. He told ABC News that the saliva testing is "equal in accuracy to nasal swabs."

The test costs $139.50 and isn't covered by insurance.

"Our discussions with several of the major insurance companies indicate that insurance does not cover testing solely for the purpose of attending a leisure or entertainment event, or for travel," he said.

The test mainly will be used by those paying for the convenience of quickly being able to attend events such as professional sports or the theater, catering events through the state's Excelsior Pass app program, or taking an international flight, Reich added.

Gov. Andrew Cuomo announced the launch of the Excelsior Pass program last month to confirm an individual's recent negative COVID-19 test or proof of vaccination, data that could be used to help venues reopen in accordance with state Department of Health guidelines. Venues that announced they'll use the app include Madison Square Garden and the Times Union Center.

Results from saliva tests should be available within 48 hours, but about 85% will be available within just 24 hours.

To take the test, patients can't eat or drink anything, brush or floss their teeth or use mouthwash, or smoke or chew gum for one hour prior. The test also can be administered to young children, who may find it more comfortable than a nasal swab.

The tests use the "same, highly accurate polymerase chain reaction technology" as PCR nasal-swab tests that detect the genetic material of the virus.

"I've been dying to go back to theater and just public events," said Reich, adding that these tests also will allow for larger catered events such as big weddings. "We think this is an excellent effort by the state to help reopen New York, and we're very pleased to be part of it."

Anne Wyllie, an associate research scientist in epidemiology at Yale University who helped develop the COVID-19 saliva testing program SalivaDirect, said this method is effective. SalivaDirect received emergency use authorization from the FDA in August and is being used in 36 states at universities and local schools.

She said she thinks testing will continue for the foreseeable future.

"We're already seeing what happens when people start going in thinking that vaccines are going to cure everything, and cases surge again," Wylie said. "We have new variants, I think testing is definitely going to be a thing, at least for schools."

Copyright © 2021, ABC Audio. All rights reserved.


Adult acne explained: Experts weigh in on over-the-counter solutions and best treatments

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(NEW YORK) -- Since the COVID-19 pandemic began, many of us have been looking to learn more about adult acne and the best treatments.

Whether you are dealing with maskne, which is caused by prolonged face mask wear, pandemic-related stress or you simply haven't had the ability to access dermatologists as quickly as you used to, these are all valid reasons for why more adults are experiencing acne breakouts.

Experts agree that there's long been a misconception that only teenagers are affected by acne. However, the skin condition can actually be experienced by people of all ages.

"All acne begins as a clogged pore, which is often filled with dead skin cells, sebum and sometimes bacteria," dermatologist and founder of Tone Dermatology, Dr. Caroline Robinson told GMA.

"Hormonal fluctuations related to menstrual cycles and menopause can lead to increase sebum production and make women, in particular, more susceptible to acne as they get wiser," she said.

Dr. Caroline Chang, dermatologist and founder of Rhode Island Dermatology Institute pointed out to GMA that most adults dealing with acne didn't deal with it during their teen years. She also highlighted the importance of treating it as its own separate diagnosis, because the causes differ.

She shared that three common causes of adult acne include:

Hormonal cause (in women)
Hormonal imbalances throughout different phases of a woman's life can lead to acne breakouts. Women can get breakouts around their period, during pregnancy, or during perimenopause or menopause. It is also possible to get breakouts when starting or stopping birth control pills. This type of acne is usually seen on the chin or around the jawline.

Stress
Stress causes an increase in androgen hormones, which stimulate increased oil production and inflammation in the skin. This type of acne can be seen anywhere on the face.

Rosacea
Rosacea can cause pimple-like bumps called "acne rosacea." This type of acne is usually seen on the cheeks, nose, chin and wherever there is background redness, such as broken capillaries, that indicate a background of rosacea.

When you have adult acne, it's also important to be mindful that though we are going through unprecedented times, there are specific ingredients that can be found in over-the-counter products that don't require a prescription.

"Because adult acne is related more to hormones and inflammation, don't reach for traditional acne products that work to clear out superficial pores," Chang advises. "These can be irritating or drying to the skin and also don't address the root concern."

Top ingredients to look for when treating adult acne, according to experts:

Topical retinols: Topical retinol and prescription retinoids are important active ingredients in the treatment and prevention of acne. They work by removing dead skin cells from the surface of the skin to help unclog pores. T

Salicylic acid: Salicylic acid is a beta-hydroxy acid that works by making the skin cells themselves less sticky. This encourages exfoliation and unclogs pores. Salicylic acid works best for comedonal acne, also known as whiteheads and blackheads.

Benzoyl peroxide: Benzoyl peroxide is an anti-microbial ingredient that helps remove excess oil and bacteria from the skin to improve the appearance of acne especially inflammatory acne that creates red or raised bumps.

Niacinamide and saw palmetto: These ingredients are best for combatting androgen signals that cause both hormonal and stress-induced acne.

Sulfur-based: Sulfur-based products work best for calming breakout caused by acne-related rosacea.

Robinson and Chang's top OTC treatment products for adult acne:

Black Opal Blemish Control Bar - It's a great over-the-counter option for acne because of its exfoliating and pore-unclogging ingredients such as salicylic acid. Because the bar also incorporates nourishing ingredients, it leaves the skin feeling clean and never stripped.

PCA Skin BPO 5% Cleanser - It's a 5% benzoyl peroxide cleanser formulated with aloe and other calming ingredients to both treat acne and the irritation commonly associated with it.

La Roche-Posay Effaclar Adapalene Gel 0.1% Topical Retinoid for Acne - It contains adapalene, a prescription-strength retinoid, that is now available over the counter and helps treat new and existing acne.

Younique You-ology brightening mask - It has niacinamide (vitamin B3) and Kakadu plum (vitamin C) both of which have strong anti-inflammatory properties that can help calm and prevent inflammatory acne bumps from surfacing.

Hero Mighty Patch Original - These patches are great because they are gentle but effective in preventing you from picking, popping or squeezing an inflamed bump, giving it time to heal on its own.

Peter Thomas Roth Therapeutic Sulfur Mask - This is a good soothing mask for rosacea flare-ups, and this one has 10% sulfur along with aloe vera to calm the skin.

If you continue to experience adult acne breakouts after using OTC treatments, it's highly advised to make arrangements to visit a dermatologist, as prescription-strength medication may be needed.

Copyright © 2021, ABC Audio. All rights reserved.


Research shows promising development in hunt for HIV vaccine

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(LA JOLLA, Calif.) -- After more than 30 years of attempts, there may be a promising advance in the search for a vaccine for HIV, the virus that causes AIDS if left untreated.

Now, preliminary data from an early stage clinical trial out of the International AIDS Vaccine Initiative and The Scripps Research Institute in La Jolla, California, suggests that a new HIV vaccine may hold promise.

"These are very early studies. But nonetheless, they are provocative," said Dr. William Schaffner, a professor of preventative medicine and infectious diseases at Vanderbilt University in Nashville, who was not involved in the clinical trial.

Although the vaccine candidate will still need to be tested in larger studies, experts are hopeful this vaccine might succeed where others have failed.

"This is a very innovative approach to developing a vaccine that hasn't been done before," Schaffner said, who described the underlying vaccine technology as "kind of a culmination of 21st century science."

When HIV was first discovered as the cause for AIDS in the early 1980s, researchers thought that a vaccine for this virus could be created rapidly, as had been done for diseases like measles, chickenpox and hepatitis B. In fact, the then-U.S. secretary of health and human services, Margaret Heckler, predicted in 1984 that a vaccine would be available in two years. Researchers soon found that there were more hurdles than they had initially thought.

HIV is a virus that mutates rapidly, creating a moving target for vaccines. HIV also has many different subtypes, so a vaccine offering protection against one subtype of HIV may be ineffective against another.

The new research out of IAVI and Scripps aims to address these difficulties by developing a vaccine that helps the body create "broadly neutralizing antibodies." The researchers hope to stimulate a person's immune system against many HIV variants and mutations.

This research is based on "identification of a subset of HIV-infected individuals ... who, in the course of their infection, do make so-called broadly neutralizing antibodies, which basically means these antibodies are able to potently block infection of diverse HIV variants, and that is the key goal," said Dr. Mark Feinberg, Ph.D., the CEO of IAVI.

Their early stage, phase 1 clinical trial, which is still underway, involved 48 healthy adults who received a total of two doses of either the vaccine or placebo, two months apart. Preliminary data showed 97% of those who received the vaccine had early evidence that their immune system may be able to make these broad antibodies.

"The broadly neutralizing antibody is important, because the virus can mutate so rapidly that they need something that's a shotgun, not a rifle ... to prevent a whole variety of different kinds of HIV configurations," said Schaffner.

The decadeslong search for an HIV vaccine lies in stark contrast to the development of vaccines for COVID-19, "where the science was ready, and we were able to develop vaccines, plural, very, very quickly," Schaffner added.

The researchers at IAVI and Scripps are collaborating with companies, like Moderna, to harness the mRNA technology used in the development of vaccines against COVID-19.

Sara Yumeen, M.D., is a preliminary-year internal medicine resident at Hartford Healthcare St. Vincent's Medical Center in Connecticut and is a contributor to the ABC News Medical Unit.

Copyright © 2021, ABC Audio. All rights reserved.


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