New antibody therapies may cut deaths, reduce exposure to COVID-19, data shows

Bill Oxford/iStockBy SASHA PEZENIK, ABC News

(NEW YORK) -- While the push to get Americans vaccinated continues across the country, preliminary data has emerged that lab-created monoclonal antibodies could be a treatment for COVID-19.

The pharmaceutical company Regeneron said Wednesday its antibody cocktail appears to hold up against the U.K. and South African variants.

Researchers at Columbia University and Regeneron scientists each independently confirmed in tests the antibodies' success in neutralizing both variants.

The data is still preliminary and under peer review but could signal a useful tool as new mutations of the virus emerge.

Regeneron's antibodies have not been tested against the Brazilian viral variant yet, but the company said it expects the cocktail to remain "similarly potent."

Eli Lilly on Tuesday said its combination of two antibodies were effective in COVID-19 patients at high risk of severe infection, reducing the risk of hospitalization and death by 70%, according to results of a final-stage trial.

That same day, Regeneron announced that its monoclonal cocktail had shown positive initial results in being used prophylactically, helping ward off the virus in those who may have been exposed to the virus. Regeneron Chief Scientific Officer Dr. George Yancopoulos said he hopes the drug "may be able to help break this chain" of active infection and transmission.

Eli Lilly also released data last week showing its antibodies may help prevent disease and stop outbreaks among nursing homes.

Currently, Regeneron's cocktail of casirivimab and imdevimab, and Eli Lilly's single bamlanivimab, have received emergency authorization from the Food and Drug Administration. They are meant to be used in the early stages of infection for non-hospitalized patients 65 and older and for those at high risk of severe illness to help keep them out of the hospital. The cocktails must be administered within days of diagnosis and are only for those with moderate to severe symptoms.

The government spent millions of dollars to make doses available to anyone who qualifies for it.

Such therapies could be an important tool in mitigating severe cases while also alleviating some of the pressure on strained health care systems.

Eli Lilly's news may signal one important mile marker: Combined antibodies bamlanivimab and etesevimab, working in tandem, may prove effective against a "broader range" of COVID-19 variants, company representatives said. This could be an essential tool as mutant strains continue to emerge.

With the new data in hand, Eli Lilly said it intends to begin global submissions for its combination therapy and request emergency authorization to use the single antibody bamlanivimab as a post-exposure "passive vaccine" treatment in nursing homes.

The "passive vaccine" use of monoclonals could offer stopgap protection, which works immediately against the virus, until enough of the population receives the vaccine required to reach herd immunity.

The FDA must still review last week's developments from both Eli Lilly and Regeneron to determine if the companies can bring these drugs to market for these new purposes and in these new forms.

The limited authorization under which Eli Lilly and Regeneron currently operate has rolled out in infusion centers across the country, with the Department of Health and Human Services building an interactive, national map tool to help locate where monoclonal antibody therapeutics have been recently received and are available for use.

Yet despite their availability and encouraging safety and effectiveness profiles, uptake of the therapies has been sluggish and "disappointing" in the U.S. -- as of the end of 2020, just 20-25% of supply had been used.

Besides lack of public awareness, an arduous infusion process, and staffing, have been a barrier to higher use of the therapies: health care systems are "crashing," Dr. Janet Woodcock, therapeutics lead for Operation Warp Speed, said in mid-January. Meanwhile, medical personnel are needed to help administer infusions even as ICU's desperately need them, too.

ABC News' Sony Salzman and Eric M. Strauss contributed to this report.

Copyright © 2021, ABC Audio. All rights reserved.

Ricki Lake reflects on 'debilitating' hair loss, reveals she's found pandemic love


(NEW YORK) -- Ricki Lake said she feels the best she's ever have one year after revealing a 30-year battle with hair loss.

The former talk show host and actress appeared live on Good Morning America Wednesday, sporting a new look.

"It was such a right of passage last year taking the leap of faith to shave my head, and my hair, thankfully, has grown back," Lake said. "And I learned so much through the process of really letting go of something that had been really bothering me for decades."

On Jan. 3, 2020, Lake opened up to Robin Roberts about the hair loss condition she was experiencing in secret, which she described as "debilitating, embarrassing, painful, scary, depressing, [and] lonely." It was the first time she ever discussed it publicly.

Lake, who took third place in the 13th season of Dancing With the Stars, explained on Facebook that when she starred in Hairspray in 1988, her hair was damaged to the point of no return.

Lake had also blamed her career as a public figure, hormones, crash dieting, weight fluctuations and genetics for the hair loss.

She said she tried a hair treatment and wore hair extensions as remedies.

"I've been to many doctors, gotten steroid shots in my head, taking all the supplements and then some," Lake wrote on Facebook. "My hair would recover and then shed again. It was maddening."

Lake said sharing her situation was one of the hardest things she's ever had to do, recently opening up to People magazine about how difficult it was.

"There's things in life where you keep them as a secret," she said on GMA. "I was molested as a child. I kept it quiet for many, many years and once you admit that it happened to you, the secret doesn't feel like this weight on your shoulders. And for me, it's been such a beautiful gift to be able to come clean with something that I was so ashamed of."

Lake said the COVID-19 pandemic made her realize the hair loss was no longer an issue.

"I've come to embrace not only my hair that has grown back, but also the color," the 52-year-old said of her silvery locks. "This is my natural color and as a society as women, we're not supposed to embrace aging."

Lake's advice to others experiencing hair loss is internal self love.

"I really, really love myself even more for being courageous during that dark time," Lake added.

Lake said she's considered writing a book about her "liberating" hair loss journey. She said there was an outpouring of support after she shared her story in 2020.

"Countless people have come to me wanting to applaud me and also say, 'Where did you find the courage?'" Lake said. "And if I can help one woman by sharing my story, it's worth it."

On Wednesday, Lake also revealed that she found love amid the pandemic.

"It's all a miracle. My hair is back and I found love during COVID," she said. "That is my beautiful partner, Ross, and he is amazing. I met him, I was on a COVID walk, I ran into an acquaintance. He said, 'Are you single?' I said, 'Yes' and I am so happy."

In 2017, Lake's husband, Christian Evans, took his own life. At the time, Lake released a statement on Instagram following the news of his death, saying that Evans had been battling bipolar disorder for years.

"Most people who have been following my story know I lost my husband to mental illness and suicide almost four years ago and I never, ever thought I'd find true love again and I consider myself a very lucky woman," she said.

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 © 2021, ABC Audio. All rights reserved.

What we know so far about COVID-19 variants worldwide


(NEW YORK) -- Scientists around the world are on the lookout for new COVID-19 variants, which are caused by mutations of the virus when its replication machinery makes an error. Experts say these mutations and the new variants are normal and to be expected.

In recent months, so-called variants of concern have been identified in the U.K., South Africa, Brazil and in the U.S. And it's not a coincidence they're appearing in these countries, which have been overwhelmed by the sheer number of COVID-19 cases.

Finding variants by screening COVID-19-infected patients with genomic sequencing is the easy part. The difficult part is then figuring out what these mutations mean. Researchers are studying the variants daily to gain a better understanding of their differences.

While we still don't know a lot about how the mutations in these variants change the virus, we do have evidence that some might be more transmissible. But there's no strong, solid evidence to date demonstrating that these variants are more deadly or resistant to current vaccines.

UK variant (B.1.1.7)

The U.K. variant was one of the first identified "variants of concern." It's estimated to have first emerged in September, and it quickly gained a foothold, spreading like wildfire throughout the U.K. and then other parts of the world. At least 293 cases have been reported in the U.S., according to the Centers for Disease Control and Prevention, which said the actual tally probably exceeds that.

There's good evidence this variant is more transmissible, spreading more easily and more quickly. This increased transmissibility is believed to be due to mutations in the spike protein -- the part of the virus that allows it to "stick" to cells. This spike protein is what the vaccines target.

The most worrying part about mutations in the spike protein is concern over it potentially rendering vaccines ineffective. Reassuringly, Pfizer now has two studies -- neither peer reviewed -- that demonstrate the vaccine is effective against laboratory-made viruses that have the mutations of this variant.

Last week, the U.K. said that there's concern that the variant might be more deadly. Sir Patrick Vallance, the U.K.'s chief scientific adviser, said early evidence suggests the variant could be about 30% more deadly, but there was "a lot of uncertainty around these numbers."

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Joe Biden, told ABC News that U.K. researchers "became convinced that it's more virulent ... so I believe their data."

Still, other scientists say it is also possible that the increased mortality rate is from the U.K. medical system being completely overrun by patients falling ill with the virus, leading to more deaths. More research is underway to determine if this strain truly is more deadly.

South African variant (B.1.351)

In South Africa, another "variant of concern" was discovered in a patient sample from October. It shares some of the mutations of the U.K. variant, but it developed independently in South Africa, from which it has spread to neighboring countries and a few others off the continent.

Like the U.K. variant, it has mutations in the spike protein. Evidence has shown it to be more transmissible, which is most likely due to these mutations in the spike protein.

But unlike the U.K. variant, preliminary findings indicate that current vaccines could have slightly diminished efficacy.

"This South African variant is somewhat less susceptible to those antibodies [produced after vaccination]," said Dr. David Montefiori, a professor and virologist at Duke University Medical Center. "It's not completely resistant, but it is somewhat less susceptible ... maybe only 85% or 90% effective."

On Monday, Moderna released data showing its vaccine still produces "protective" antibody levels for both the U.K. and South African variants, but those antibody levels were diminished in the South African variant. The company is now launching studies of an experimental booster shot of its vaccine adjusted to address this.

Brazilian variants (B1.1.248 & P.1)

Two variants have been detected in Brazil. The first (B1.1.248) was detected in four Japanese travelers traveling from Brazil. The second variant (P.1) appears to be the major variant in Brazil, in particular in the Amazonian Manaus region. The two variants are related, but scientists are more concerned about P.1 because evidence suggests it's more transmissible given its spread and dominance in Brazil.

Scientists also are concerned that P.1 might escape a person's natural immunities after an individual recovers from a COVID-19 infection, leaving them more vulnerable to reinfection. That's because some people are getting reinfected with this variant after a prior infection. Some experts believe that it might have the ability to escape previously generated antibodies. But at the moment, these are just theories and no solid evidence has demonstrated this, and current vaccines should remain effective.

US Midwest variant (20C-US or COH.20G/501Y)

Over the last month, there have been three variants that have been discovered in the U.S., the first of which was found by two groups in the Midwest (20C-US or COH.20G/501Y). It was traced back to a patient sample in May and has taken over the Midwest and much of the country -- possibly now in half of all U.S. samples.

This variant has spike protein mutations different from both the U.K. and South African variants. Little is known about this variant and more research is needed to characterize it, but some researchers believe it could be more transmissible. Current vaccines should still work, they said.

US San Francisco Bay Area variant (L452R)

In hard-hit California, two variants were identified last week. The U.S. San Francisco Bay Area Variant was identified in patient samples from October. It's believed to be the culprit of multiple large outbreaks throughout the Bay Area, and with increasing numbers around California, there's concern it has increased transmissibility.

"It's still very early in terms of what we know about this particular variant," said Dr. Charles Chiu, director of the UCSF-Abbott Viral Diagnostics and Discovery Center and associate director of the UCSF Clinical Microbiology Laboratory. "What we can say is that it is increasing in number ... and in frequency, in terms of the proportion of infections that are caused by this."

US Southern California variant (CAL.20C)

Another variant was found in Southern California, the epicenter of the U.S. pandemic. It first appeared in July and is now the predominant variant in the region. Dr. Jasmine Plummer, Ph.D., associate director of the Genomics Core at Cedars Sinai told ABC News that in December about 40% of all samples contained that variant and "it's still rising."

Little is still known about both California variants. Experts still aren't sure if they're more transmissible or if the variants are responsible for more cases because of the severity of the pandemic in California.

Fauci said that more transmissible variants are a concern because more transmission leads to more cases and more hospitalizations, which means that "you ultimately will get more deaths."

Copyright © 2021, ABC Audio. All rights reserved.

Avoid preventive pain relievers before getting a COVID vaccine: Experts

simon2579/iStockBy DR. SEAN LLEWELLYN, ABC News

(NEW YORK) -- COVID-19 vaccines from Pfizer-BioNTech and Moderna are being offered to an increasing number of people. Vaccine recipients typically experience minimal side effects -- the most common being temporary pain and swelling at the injection site, fevers, chills, tiredness, muscle aches and pains and headaches.

While these side effects are generally a minor nuisance to most people, some attempt to prevent them by taking common over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (e.g., Motrin, Advil) beforehand. However, experts said these medications might not just dull the pain, but they may dull the vaccine from fully working.

“We do not recommend premedication with ibuprofen or Tylenol before COVID-19 vaccines due to the lack of data on how it impacts the vaccine-induced antibody responses,” Dr. Simone Wildes, an infectious disease specialist at South Shore Medical Center and a member of Massachusetts’ COVID-19 Vaccine Advisory Group, told ABC News.

The side effects from the vaccines are caused by activation of the immune system, meaning that the immune system is working and starting to build immunity to COVID-19 -- this is what we want. These pain relievers may prevent parts of the immune system from working and slow down the immune response. There is a theory that taking these medications before immunization may reduce their effectiveness.

A study from Duke University found that children who took pain relievers before getting their childhood vaccines had fewer antibodies than those who did not take the medications, which could mean less protection. However, there were still protective antibody levels, despite the blunting.

“You always would like an optimal response to your vaccine,” Dr. William Schaffner, an infectious disease specialist and professor of preventative medicine at Vanderbilt University Medical Center, told ABC News. “We are recommending that unless people have a substantial reaction to the first dose that they hold their [pain killers]."

"The vast majority of people have a bit of a sore arm," said Schaffner, "but otherwise, they feel pretty well.”

While experts recommend against taking over-the-counter pain relievers before getting the vaccine, they say you should continue taking them if you are already doing so for another medical condition. Schaffner warned that stopping these medications could cause unintended problems and be more harmful than beneficial.

The Centers for Disease Control and Prevention recommends that after getting your shot, you should monitor for the side effects. As pain relievers and fever reducers are not intended for use before symptoms appear, talk to your doctor before vaccination to decide if you should take any over-the-counter pain relievers after receiving the shot.

Other, more natural ways to reduce pain and discomfort include: applying a clean, cool, wet washcloth over the injection site and moving or exercising your arm. And for a fever, drink plenty of fluids and dress lightly.

“If fever, chills, headaches develop after injection,” use pain relievers to help with your symptoms, but not before they develop and report any significant side effects to a medical professional, Wildes said.

Copyright © 2021, ABC Audio. All rights reserved.

What to know about the link between mental health and heart disease

AaronAmat/iStockBy KATIE KINDELAN, ABC News

(NEW YORK) -- A connection between mental health and heart health has been confirmed by the American Heart Association.

The AHA cites a "growing body of research" that shows good mental health can reduce the risk of cardiovascular disease and improve overall heart health in its statement, published Monday in the medical journal Circulation.

"There is increasing evidence that psychological health may be causally linked to biological processes and behaviors that contribute to and cause CVD [cardiovascular disease]," the statement reads, in part. "The preponderance of data suggest that interventions to improve psychological health can have a beneficial impact on cardiovascular health."

For those with cardiovascular disease, the AHA recommends mental health screenings done by health care providers and mental health as part of the treatment process.

Dr. Jennifer Ashton, ABC News' chief medical correspondent, describes the types of mental health screenings that health care providers should provide as "a checkup from the neck up."

"Cardiologists should not just be listening to [a patient's] heart, but they should be looking at them and listening to their words and their feelings to see if they need intervention from a mental health or mental wellness perspective," Ashton said Tuesday on Good Morning America. "But also, the primary care physicians, the health care providers that are seeing people before they have a diagnosis of heart disease need to be doing a checkup from the neck up."

"They need to ask how people are from a mental health standpoint," she said.

Ashton said that mental health conditions including depression, anxiety, stress, PTSD, isolation, loneliness, pessimism and anger can have negative health risks, including heart complications.

Likewise, positive mental health conditions like optimism, mindfulness, emotional vitality and overall psychological well-being are good for the heart, according to Ashton.

"When we can’t see something we take it less seriously but we need to understand that mental health is not just the absence of something wrong," she said. "There are steps we can take to promote it and we need to get aggressive about that."

The AHA's statement on the link between mental health and heart health comes as the ongoing coronavirus pandemic continues to have a negative effect on people's mental health.

Across the country, 45% of adults say the pandemic is having a negative effect on their mental health, a rate that increases for women, and Hispanic and Black adults, with those populations more likely to report a "major" mental health impact, according to a tracking poll released last year by the Kaiser Family Foundation.

Heart disease is the leading cause of death in the United States, causing about one in four deaths, according to the Centers for Disease Control and Prevention.

Ashton recommends using mindfulness practices and meditation as well as journaling and therapy to help reduce anxiety, depression and stress.

"Journaling has been found by psychologists to be even as effective or sometimes more effective as talk therapy but again for those people who are suffering, mental health professionals are there for exactly this reason," she said. "There is no shame in asking for help."

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 © 2021, ABC Audio. All rights reserved.

LA County Fire Department COVID cases dramatically decrease after 75% get vaccinated

Ridofranz/iStockBy DR. ADJOA SMALLS-MANTEY, ABC News

(NEW YORK) -- Currently available COVID-19 vaccines worked well in clinical trials, and now we're seeing evidence they're protecting people in the real world -- even after one dose.

The Los Angeles County Fire Department has seen a dramatic decrease in its COVID-19 positivity rate since firefighters started getting vaccinated during the last week of December.

Approximately 75% of the county’s firefighters, over 3,000 people, have received their first dose of the vaccine. In December, their COVID-19 positivity rate was 18%. It has dropped to 5.6%.

This trend is in stark contrast to what is being seen in L.A. County, now the U.S. hub of the pandemic, and California, which became the first state to surpass three million COVID-19 cases.

Like other frontline workers, firefighters put themselves at risk every day.

“As an emergency room physician, and for paramedics and EMS providers and firefighters, we are constantly encountering patients where we do not know the risks, we do not know about their status,” said Dr. Darien Sutton, an LA-based emergency medicine physician and ABC News Contributor.

“I think there was a lot of excitement over the possibility of having an increased level of protection because these people are inside the homes of these highly viral patients and transporting them to the hospitals, so if anyone should be protected, of course they should be," Sutton said.

The dramatic decline in positivity rates was seen just after the first shot. The firefighters that received their first shots in December began getting their second shot starting last week.

Getting immunized is the best way to reduce a person’s individual risk of infection in addition to precautions like wearing a mask, social distancing and hand washing. Experts stress, however, that one shot isn't enough -- everyone needs two shots of either the Moderna or Pfizer-BioNTech vaccine for that 95% protection.

Experts said that the positive experience of firefighters, and other stories showing the vaccines are working, might help encourage those who are reluctant or scared to get the vaccine.

“As more and more health care providers started to participate, it kind of had this herd effect where people were like, 'ok, let me.' If you see your friends and coworkers getting it, you’re going to realize the opportunity and benefits of you getting it,” Sutton said.

Getting vaccinated also helps others and is necessary for herd immunity. Herd immunity is when enough people in a population develop immunity to the virus so it reduces the spread in a population even to those who lack immunity. The fewer people get sick, the less likely someone is to pass on the infection.

Experts warn that we may not see a return to our normal routines until herd immunity is reached. That may require 70-90% of the population being vaccinated.

By getting the vaccine, these firefighters are reducing their risk of having the infection and passing it to members of the community they serve daily.

“I think it’s wonderful,” Sutton said. “It’s a great anecdotal piece to show the possibility of great effectiveness. I think this is one of those cool examples where we have some glimmer of hope of what might be expanded upon in a larger population. We might be able to get to that vaccine-induced herd immunity.”

Copyright © 2021, ABC Audio. All rights reserved.

Woman loses 115 pounds, leads organization that gets Black women running

Courtesy Jay Ell Alexander By KATIE KINDELAN, ABC News

(NEW YORK) -- Jay Elle Alexander credits running with helping her lose 115 pounds.

The 33-year-old mother of a 16-month-old son is now the CEO of Black Girls Run, an organization that encourages Black women to take charge of their health through running.

"When you’re trying to lose weight or get healthier, it’s not easy, especially when you’re in your 30s, 40s and 50s," Alexander told ABC News' Good Morning America. "Having people who look like you that share in that experience, I think just means so much from a support standpoint, accountability and people just to encourage you on the pavement."

Alexander, of Richmond, Virginia, started working with Black Girls Run, a national organization, around a decade ago after finding herself often as the only Black woman in running groups and at races.

"Back then, there were not African American women running in 10Ks, half marathons and so forth," said Alexander, who started running after a doctor told her she needed to get healthier. "When you go to a training team and you see the only one other Black woman there, you sort of gravitate to each other."

It was her leadership position with Black Girls Run in 2019 that motivated Alexander to recommit to getting healthy after the birth of her son that same year.

"I hit my heaviest weight in September 2019, when I gave birth to my son," she said. "Because I lead [Black Girls Run], I thought this is really a time for me to be an advocate for the mission that I preach."

Alexander said she made changes to her diet and recommitted to running, setting a goal to run the Miami Marathon in February 2020, just four months after giving birth.

"I started signing up for virtual races, being conscious of my eating, getting my husband involved and getting him running too," she said, noting that her husband has lost around 50 pounds. "We took a family and team approach in terms of weight loss and meal planning."

One year later, Alexander had lost 115 pounds, a weight loss she's maintained for the past nearly five months.

"Now I have my own personal journey to share with other women, letting women know that it’s not easy and if I can do it, I know everyone else can," she said. "I’m being an advocate and walking the walk of the mission that we preach every day."

The mission of Black Girls Run is to get Black women active and committed to a healthy lifestyle, according to Alexander.

Black women in the U.S. are more likely to die from pregnancy or childbirth than women of any other race, according to the U.S. Centers for Disease Control and Prevention (CDC).

They also have a life expectancy that is four years shorter than white women, according to the U.S. Department of Health and Human Services (HHS). Black women also have higher rates of deadly diseases including heart disease, stroke and diabetes, data shows.

The reasons for Black women's worse health outcomes range from lack of access to quality health care to income inequality to systemic racism in the medical field, experts say.

"Compared to white women, Black women are more likely to be uninsured, face greater financial barriers to care when they need it and are less likely to access prenatal care," according to a 2018 report from the National Partnership for Women and Families, a nonprofit organization focused on improving the lives of women and families.

Many of the women who train with Black Girls Run say they were intimidated by the sport before finding the organization, according to Alexander.

"A lot of the women that are joining our community .... want to reinvest in themselves. They want to join a community of women who look like them to say, 'This is my time,'" she said. "We want women to just become healthier and just start moving."

Alexander said her biggest tip for women who want to make a health transformation is to remember that their journey is their own, different from anyone else's.

"The health and fitness journey is not overnight. It’s truly a lifestyle. That’s the part that people have to understand and really acknowledge," she said. "Every day is not going to be a good day. Every run is not going to be a good run."

Another tip is to make sure that you start your weight loss or exercise journey with a "healthy mind," according to Alexander.

"The first step would be to get your mental health where you’re a place where you’re ready to take that next step," she said. "You have to be ready to get up off the couch and put your shoes on or wake up at 6 a.m. to put the [exercise] DVD on. If you’re not in that sound mind, take your time."

Copyright © 2021, ABC Audio. All rights reserved.

VIP vaccines: As availability tightens, the wealthy and well-connected push for access

simon2579/iStockBy SASHA PEZENIK, ABC News

(NEW YORK) -- Direct and immediate access to their doctor is part of what Dr. Abe Malkin's patients pay for. Concierge practices like his tout first class, round-the-clock medical care. Malkin rarely silences his cellphone, so as not to miss anything, or anyone.

But since the COVID-19 vaccine made its U.S. debut, Malkin says his entire team has been "bombarded" by calls asking when they can get it, or if their names might be bumped up to the priority lists.

Some simply ask whether it's possible -- others ask if there's a purchase price.

The vaccine's slow and uneven rollout has worn public patience thin, and fomented fears that affluence may expedite access. Now, as expanded eligibility amplifies demand, while reserves run short and wait times grow longer, experts warn that the wealthy and the well-connected may be further incentivized to exploit the ensuing chaos -- and those who can pay for the privilege have been shopping for a way to get their arms ahead in line.

"I get call after call every day now, people saying, 'I'm going to join whichever practice is able to get me the vaccine first,' and they're willing to pay a premium for that access," Malkin, the founder of Concierge MD in Los Angeles, told ABC.

"With five-star prices, expectations are higher," Dr. David Nazarian of My Concierge MD in Beverly Hills told ABC. "These people are used to having things when they want it."

Boutique medical practices like these offer personalized, executive care -- for a fee. The annual cost runs anywhere from $5,000 to tens of thousands, depending on the practice. And some patients are now offering to pay even more if it means getting a fast-tracked vaccine.

"They offer to make a donation to charity, the hospital, or just pay extra," Nazarian said.

He and Malkin tell ABC News that they've heard offers upwards of $25,000 to jump the line -- all of which they've politely declined.

"Babe, can i come w sis and husband and one other ... for vaccine … do you have it," read a text message from an actress and social media influencer that was sent to a concierge service and obtained by ABC News.

"Not yet, and it's only going to be distributed to at-risk populations first," the concierge service replied.

"These are people who, when testing first came out in March, wanted testing. When hydroxychloroquine was in short supply in April, they wanted hydroxychloroquine. When Regeneron was announced, they wanted that," Malkin said. "This is just the latest example."

Asking doesn't mean getting -- and in interviews with ABC News, concierge doctors maintain they've held firm to their local prioritization guidance, and experts say that so far abuse of the vaccine rollout has not run rampant. But a few high-profile cases have drawn national condemnation, and authorities say they're carefully watching for any signs of unethical line-cutting.

Earlier this month, MorseLife Health System, an elite nursing home and assisted-living facility promising "an atmosphere of luxury, outstanding service, and compassionate care" in West Palm Beach, Florida, became the subject of an investigation by the Department of Health and the state's inspector general for allegedly making vaccines available not just to its residents and staff, but to board members and those who have made generous contributions to the facility, including members of the Palm Beach Country Club.

Real estate mogul David Mack, who is vice chairman of the Morse Health System Board of Trustees and also sits on the Palm Beach Country Club's Board of Governors, acknowledged that he and his brother Bill Mack, who is also in real estate, had "assisted" with MorseLife's vaccination campaign -- but refuted reports that this was a "targeted effort to vaccinate members of the Palm Beach Country Club."

In a statement to ABC News, the brothers said that the shots had been administered "in full accordance" with the governor's executive order that shots be given to medical workers, residents and staff of long-term care facilities, and adults 65 and older.

Since 2016, the Palm Beach Country Club Foundation has contributed at least $75,000 to MorseLife Home Care, according to tax filings.

Walgreens, whose staff was on site providing vaccines at MorseLife, said it was unaware that any shots were being given unfairly.

"Walgreens was led to believe that the individuals receiving the vaccine were either residents or staff," a Walgreens spokesperson said in a statement to ABC News. "We are disappointed to learn that ... some recipients of COVID-19 vaccines at this facility may not have qualified as defined by the state's guidance."

MorseLife did not respond to numerous requests for comment by ABC News.

Florida Sen. Rick Scott has called for a congressional investigation, calling it "absolutely disgusting and immoral that anyone would take vaccines intended for nursing home residents to distribute them to their friends."

Democratic State Rep. Omari Hardy, who represents the area of West Palm Beach that includes MorseLife, denounced facilities appearing to be "selling access to the vaccine."

"I'm concerned, going forward, that we don't have a robust plan to make sure that the distribution of this vaccine is equitable," Hardy said.

"What we've got is a breakdown in the equitable distribution, which has caused distrust in the entire public forum," Republican State Rep. Mike Caruso, whose district covers Palm Beach County, told ABC News.

MorseLife is not the only instance of alleged preferential treatment of which Caruso says he's been made aware. Baptist Health South acknowledged to ABC News that "established Baptist Health supporters" have been among those prioritized for the vaccine despite limited supplies, adding that they had been "reaching out to eligible high-risk members of the Baptist Health community" who "meet criteria" for the shots. Recipients were "age 65 or older" in high-risk groups, a spokesperson for Baptist Health said.

"Doctors have called me up and told me this was happening," Caruso said. "This diamond, platinum access to vaccine for foundation members or contributors -- that's just wrong."

With expanded eligibility, Malkin said concierge doctors anticipate "a lot more wiggle room" in their ability to prioritize preferred clientele for the shot -- even as competition to get the vaccine intensifies.

And with expanded vaccine eligibility leading to a shortage of shots, experts anticipate that the competition to get the vaccine will intensify.

"It all leads to more jostling and a scramble to be the first," Arthur Caplan, professor of bioethics at New York University Grossman School of Medicine, told ABC. "The system has always had special pathways for the rich -- and chaos helps facilitate acceleration and exploitation of those loopholes."

"That seeds anger," Caplan said. "And a real perception that behind the scenes, the rich are greasing the skids on a life-or-death situation."

As a result, the very doctors whose brand boasts the ability to circumvent some of the health system's stresses with elite care now find themselves staving off "VIP syndrome" requests from their A-list patients, in order to hold the line on medical ethics.

"It's a complicated time because we definitely want to follow the rules and we understand how complex a rollout this is," said Andrew Olanow, cofounder of Sollis Health, a concierge practice operating in New York, the Hamptons and Beverly Hills, which has been administering the vaccine to front-line workers and other high-risk patients at their New York location.

Some states have strict penalties for anyone offering sweetheart access to the shots; New York Gov. Andrew Cuomo and California Gov. Gavin Newsom have both threatened line-skipping sanctions and the revocation of the right to practice for any unethical vaccine administration.

Newsom noted that the temptation to allow line-jumping could grow as subsequent phases are rolled out.

"Not every individual may hold themselves to those higher ethical standards of the Hippocratic oath, which they've taken," Newsom said in late December. "We are mindful of that."

Ultimately, Olanow said, medical providers will still be the gatekeepers when it comes to sorting through gray areas like a patient's self-identified comorbidities or their essential-worker status.

"Providers of the vaccination will have to do their best to validate patient claims in terms of what their risk factors are, and that they're essential," Olanow said. "A good doctor or a good practice does what's right, not what the patient demands."

Copyright © 2021, ABC Audio. All rights reserved.

As nursing homes get vaccine, assisted living centers are left 'falling through the cracks,' experts say

Bill Oxford/iStockBy LAURA ROMERO, ABC News

(NEW YORK) -- As the COVID-19 vaccine rollout reaches residents of nursing homes across the country, long-term care advocates remain concerned that many of the nation's most vulnerable citizens -- who are living in similar, high-risk congregate settings -- are being left to wait.

Assisted living facilities, which range from small homes to large complexes, are aimed at older people who are largely independent but still in need of medical or personal care. Because of the communal nature of the facilities, assisted living residents face many of the same increased risks for the coronavirus as those in nursing homes.

"The risk of community spread and transmission in an assisted living facility is just as high as it is in a nursing home," said Zach Shamberg, president of the Pennsylvania Health Care Association.

It is difficult to know the extent to which residents and staff in assisted living facilities have been affected by COVID-19 because assisted living facilities are not federally regulated, so many states do not publicly collect data. But the Kaiser Family Foundation reports that more than 100,000 residents and staff at long-term care facilities had died as of November.

Advocates say the facilities house a forgotten population of people vulnerable to the virus. As COVID-19 vaccine distribution plans were crafted and began rolling out, many states did not include assisted living facilities in the same high-priority first phase to receive the vaccine.

In Pennsylvania, for instance, assisted living and personal care residents were not originally in the first group to receive the vaccine, leaving those residents to wait up to several months to get the vaccine. Just last week, Pennsylvania Gov. Tom Wolf announced his administration is expanding vaccination to long-term care facilities, and requested assisted living residents and personal care residents be included in Phase 1A.

"If we don't change the pace that Pennsylvania is on currently, we would expect assisted living and personal care residents to receive the second dose sometime in April or May or even June," Shamberg said. "We are talking about potentially still vaccinating our most vulnerable residents in the summer months."

Mike Dark, an attorney for the California Advocates for Nursing Home Reform and a member of the California Vaccine Advisory Committee, told ABC News that assisted living facilities were not prioritized because states believed they only had enough vaccines for nursing homes.

"[Assisted living] facilities are largely falling through the cracks in the distribution program and the results will be catastrophic if this isn't addressed," Dark said.

In New Hampshire, Phase 1A includes both nursing homes and assisted living residents. But officials like Brendan Williams, the president of the New Hampshire Healthcare Association, told ABC News that it has been difficult to get all long-term care residents vaccinated, even in retirement communities where assisted living and nursing home residents are in the same location.

"Even where assisted living and nursing home residents are housed under the same roof, it has taken browbeating CVS to get them to follow the state policy that in such an instance all residents should be vaccinated," Williams said.

"We can't even efficiently vaccinate our most vulnerable, place-bound citizens," added Williams. "We have a very elderly assisted living population here in New Hampshire that has not been spared deadly outbreaks."

In Indiana, a spokesperson for the Indiana Health Care Association told ABC News that independent assisted living facilities are "understandably frustrated" because scheduling for the clinics began just two weeks ago.

The overall timeline for vaccine distribution in long-term care facilities has been pushed back since late last year, when former Secretary Alex Azar told CBS' Face The Nation that all nursing home residents could be vaccinated by Christmas.

"The vaccines are going out. As soon as they receive vaccine, this is according to the governors telling us to ship to them, we can have every nursing home patient vaccinated in the United States by Christmas," Azar said.

Then, on a call with LeadingAge, an elder advocacy group, former Surgeon General Jerome Adams said he believed vaccinations among nursing home residents and workers would be completed by the end of January.

"We're going to make sure we get our nursing home workers and residents vaccinated, and it is truly our hope to have that completed by the end of January," said Adams, adding, "I really think it is an achievable timeline."

Both Walgreens and CVS, the companies responsible for vaccinating the majority of long-term care residents, say they expect to complete the administration of the first doses of COVID-19 vaccines in skilled nursing facilities by Jan. 25, with the second doses to follow.

There is no projected date for when residents and staff at assisted living facilities will be completely vaccinated.

For Mike Wasserman, the past president of the California Association for Long Term Care Medicine and a member of the California's Vaccine Advisory Committee, vaccine rollout in assisted living facilities needs to be a priority for the Biden administration.

"The challenge will be, how do we turn the Titanic around?" Wasserman said.

Many assisted living facilities in California, Wasserman said, don't have an appointment to receive the vaccine until March.

"They are not being prioritized," said Wasserman. "Residents in assisted living facilities need the vaccine just as much as nursing home residents."

Copyright © 2021, ABC Audio. All rights reserved.

Some COVID-19 variants spread more easily than original: Here’s why

Rattankun Thongbun/iStockBy DR. SEAN LLEWELLYN, ABC News

(NEW YORK) -- In recent months, new variants of the virus that causes COVID-19 have been popping up all over the world, and experts say even more will continue to be identified as this pandemic continues. In the United States, variants have been found in California and the Midwest in recent weeks, and last month, new variants from the U.K., South Africa and Brazil were identified.

All viruses naturally gain mutations, so these variants "are normal and expected," said Dr. Richard Kuhn, director of the Purdue Institute of Inflammation, Immunology and Infectious Disease and editor-in-chief of the journal Virology. For now, there's no evidence any of these new variants are more deadly or that existing vaccines won't work.

However, there is strong evidence that two of the variants -- those that were first identified in the U.K. and South Africa -- are more transmissible. Now, scientists are racing to understand exactly what it is about these two variants that makes them easier to jump from person to person, and whether we should be worried that other variants might do the same.

Although it's still unknown exactly what leads the virus to being more transmissible, there are many theories, and several of the leading theories have to do with how effectively the virus leaves your body in its search for another.

Increased virus shedding

When you cough, sneeze, talk or sing, little droplets of mucus and saliva go into the air. If you are infected with COVID-19, these droplets will contain the coronavirus. If you are infected with a variant that increases transmission, there could be more virus in each of these droplets.

“People who are infected with the variant could be shedding more [virus],” said Dr. Angela Rasmussen, a virologist and associate research scientist at the Center for Infection and Immunity at Columbia University's School of Public Health.

According to Rasmussen, preliminary data from the U.K. suggests people infected with the new variant tended to have higher viral loads -- meaning they had more volume of virus in their noses, which could be measured using a nasal swab.

With more virus in the respiratory droplets, it could be easier to get an infection if a droplet lands in your eyes, mouth or nose.

Prolonged virus shedding

In a related theory, scientists are investigating whether the new variant might somehow lengthen the number of days an infected person is contagious.

Right now, there is good evidence to show that when someone becomes infected with COVID-19, they typically shed virus for about 10 days. That's why the CDC asks people to isolate for 10 days after a positive test.

But if these variant viruses mutate to prolong this period, “they are shedding virus sooner and transmitting later, increasing the number of days [of being contagious],” Rasmussen said.

That could cause others to be infected, because you might not be quarantining when you should be and therefore exposing others unknowingly.

Increased environmental stability

Yet another idea is that the virus might have evolved to be sturdier and better able to withstand the harsh environment outside the human body.

Many viruses, including rhinovirus -- one of the culprits of the common cold -- and influenza can have alterations in their protective outer coat in cold, dry weather, making them more stable in the environment. This allows them to hang out in the air or on surfaces for longer periods of time and remain infectious, making transmission from person to person easier.

There currently is no evidence that the COVID-19 variants are more stable in the environment, as those studies have not been performed. But many other coronaviruses -- also culprits of the common cold -- have been shown to be more stable in cold, dry weather. If these variants are more stable than before, it would increase their ability to transmit.

Better able to "stick" to cells

One of the leading theories that has the most evidence behind it is the idea that the new, more transmissible COVID-19 variants are simply better at latching onto our cells.

Many scientists feel confident about this theory, because the mutations they found in the U.K. and South African variants are in those little "spikes" on the outside of the virus. The virus uses those spikes to bind to a specific site on our cells called the ACE2 receptor.

Most of the mutations “have predominantly been at the interface where the virus meets the cell receptor,” Kuhn said. "The mutations make the virus bind more efficiently to the [ACE2] receptor, resulting in great infections ... [enhancing] the spread.”

Think of the ACE2 receptor and the COVID-19 virus as a lock and key, respectively, to get into the cell. If the virus mutates to become a better fit for the lock, it will be easier to get in and infect the cell, and it will be able to infect more cells. This means that if you are exposed to a variant of COVID-19, you are more likely to get infected, because it will be easier for the virus to get into your cells.

Scientists say none of these four theories are a slam dunk, but the increased ability to "stick" to cells is the most likely culprit, given the mutations in the binding site of the spike protein. However, it could be any one of these theories, and it could be a combination of them.

There are still many questions regarding the COVID-19 variants and what they mean in the course of the pandemic, but scientists are working every day to learn about them. Each time a new variant is discovered, researchers will need to characterize the variant to understand what the mutations do and how they could alter the course of the pandemic. Researchers in the U.S. continue to recommend that everyone remain calm and wait to see what the research shows, because people might be worrying for no reason.

And they stress that the known safeguards -- physical distance and a simple face covering -- will still work to protect you.

"A mutation, no matter what, is not something that confers magical powers to the virus," Rasmussen said. "It can’t suddenly get through a physical barrier like a mask."

That means the best way to protect yourself and others from getting COVID-19 is to wear a mask, social distance and wash your hands often.

Copyright © 2021, ABC Audio. All rights reserved.

Dementia, Alzheimer's not an inevitable part of aging: Study

Goodboy Picture Company/iStockBy DR. ALEXIS E. CARRINGTON, ABC News

(NEW YORK) -- Dementia and Alzheimer's disease may not be an inevitable part of aging, according to a recent Dutch study, which identified 100-year-olds with high cognitive performance despite risk factors for decline.

This six-year study of centenarians -- people who are over 100 years old -- found that despite high levels of a brain marker associated with cognitive decline, called amyloid beta, these centenarians were still sharp and performed well on cognitive tests. The researchers concluded these elderly subjects may have resilience mechanisms protecting them from memory loss.

In fact, they said the risk of dementia may not necessarily increase once you pass your 100th birthday.

"A person between 70 and 95 years old is exposed to the same dementia risk as a person who lives between age 100 and 102," said Henne Holstege, Ph.D., of Amsterdam University Medical College in the Netherlands, who was involved in the study.

These results provide a hopeful glimmer to some that although dementia and Alzheimer's is more likely to occur with an increase in age, it won't be everyone's fate.

"Age is the No. 1 risk factor for Alzheimer's, but these findings show us that it's possible for centenarians to thrive despite their advanced age," said Dr. Richard Isaacson, director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine and New York-Presbyterian Hospital, who headed the study.

Although these findings shed light on aging and cognitive function, it still remains a complex phenomenon that needs more exploration, according to some experts.

"Dementia and Alzheimer's tend to be multifactorial conditions, meaning that a mix of genetics, age, environment, lifestyle behaviors and medical conditions that coexist together and can lead a person toward or away from cognitive decline," said Isaacson.

Researchers still aren't sure exactly why some people are protected from cognitive decline, while others are spared. The researchers in the study proposed some of these protective factors associated with cognitive performance could be education, frequent cognitive activity and even IQ. But there can be more at play.

"There could be protective immunologic and cardiovascular risk factors that help keep their brains resilient and cognitively functional even in old age," said Dr. Gayatri Devi, a neurologist and psychiatrist at Lenox Hill Hospital in New York City.

The role the brain markers analyzed in the study play on memory, including a sticky plaque called amyloid beta typically found in the brains of people with Alzheimer's, is now hotly debated among experts. The varying presence of these markers in this study further contribute to this complicated process.

"It's important to understand that the presence of amyloid in the brain does not definitively mean a person will develop dementia," said Isaacson. "There are other factors and lifestyle behaviors that can make us resilient and resistant to cognitive decline."

Importantly, there are some caveats to this study. For instance, the brain markers were only analyzed in 44 of the participants, so the findings may not apply to everyone, and more research needs to be done to learn about the complexity of aging.

Other studies have investigated prevention of cognitive decline. According to the 2020 Lancet Commission Report, 40% of dementia cases may be preventable based on modifiable risk factors. Some of these previous studies have had success in improving cognitive function and reducing risk.

A study by Isaacson's team at the Alzheimer's Prevention Clinic found it was possible to improve cognitive function and reduce risk, especially in those who followed suggestions on lifestyle modification, such as exercise, nutrition, vascular risk and medications.

Even though more is being discovered and debated, experts still recommend maintaining a healthy lifestyle, including balanced eating, exercising and doctor visits, to maintain cognition during aging.

"It's essential for people at risk to see their doctors on a regular basis and consider cognitive screening tests," said Isaacson.

Copyright © 2021, ABC Audio. All rights reserved.

Cities, states face 'a lot of uncertainty' as they exhaust vaccine allotments


(NEW YORK) -- Appointments are being canceled, sites are temporarily closing, county waitlists are in the thousands and states are adjusting eligibility timelines as vaccines supplies dwindle nationwide.

With shipments coming weekly, officials say they don't have much visibility on their supplies as they simultaneously schedule first and second doses, and plan to expand vaccination sites.

"There's a lot of uncertainty right now," Dr. Amesh Adalja, a senior scholar with Johns Hopkins Center for Health Security, told ABC News. "Everybody knows that the supply chain will be coming, but nobody knows exactly when it is coming, how much of it is coming and how steady the supply chain will be. That makes it harder to plan."

With its current supply on track to be depleted by the end of this week, and a shipment of over 100,000 Moderna vaccines delayed, the New York City health department will close 15 vaccination hubs from Thursday through Sunday, officials said.

"This is crazy," Mayor Bill de Blasio said during a media briefing this week. "This is not the way it should be. We have the ability to vaccinate a huge number of people. We need the vaccine to go with it."

Some 23,000 people expecting to receive their first dose will need to reschedule, de Blasio said Wednesday.

New York City isn't alone. San Francisco Mayor London Breed said Tuesday that the city is projected to run out of vaccines by Thursday if more don't arrive.

"We simply need more vaccines," said Breed, noting that the city had set up a new dashboard to track vaccine allotment.

As Collin County, Texas, waits for more shipments, more than 144,000 people are currently on its vaccination waitlist. Just over 1,000 doses have been administered, and 7,000 new doses were expected this week.

Residents are frustrated.

"I don't want to die of COVID. It's that simple," Plano resident Pat Parker, who said she is no. 16,793 on the waitlist, told ABC News Dallas affiliate WFAA-TV. "What did I just register for? Nothing, nothing."

The supply concerns come as many regions are expanding vaccination eligibility. On Wednesday, Los Angeles County opened it up to residents ages 65 and up -- a group that includes over one million people -- though local health officials warned that supply remains scarce. Call centers were inundated, and websites crashed as residents attempted to schedule the limited number of available appointments.

"One of the issues that everyone has had around the allocation and distribution from the federal government is it has been week-to-week, which makes it difficult for our sites to do a lot of planning, and it really makes it difficult to extend appointments past a few days, which I think then makes it hard on the public," LA County Department of Public Health Director Dr. Barbara Ferrer said Tuesday at a media briefing.

States also have had to adjust their timelines after learning late last week that they wouldn't receive as many doses as anticipated from the federal reserve. Oregon health officials said they would have to delay the expansion of doses to seniors by several weeks. Instead of starting to vaccinate all seniors on Jan. 23, the state will begin vaccinating in waves, starting with those age 80 and older on Feb. 8.

"The approach completely depends on Oregon getting a reliable supply of doses from the federal government," Patrick Allen, director of the Oregon Health Authority, said during a press briefing Friday.

The certainty around the federal supply is making it difficult to open more vaccination sites and plan more than a few weeks out, health officials in Mississippi said.

"We don't know where we're going to be in a month," Dr. Thomas Dobbs, the state health officer, said Friday during a panel with the Mississippi State Medical Association. "Since we don't have 100% visibility of the vaccine on hand for a week from now, it's too far ahead of us to plan properly."

This lack of visibility led to some confusion last week, when the state health department announced new vaccine appointments wouldn't be available for a month out. After additional supplies became available, residents are now able to make appointments as early as Jan. 25, officials said.

"We can't depend on much stability," said Dobbs, noting he expects the situation to improve in the coming weeks.

As New York City runs out of available first doses, de Blasio floated freeing up the second doses the city has on reserve.

"We've got about 65,000 doses that we could put into play right away if we had that freedom," he said. "Let's be creative and let's do something to reach the most people as quickly as possible -- and then catch up in the days ahead."

With a new administration in the White House, many leaders are hoping for more transparency on available doses and ramped-up production of the Pfizer's and Moderna's vaccines. Other COVID-19 vaccine candidates, such as Johnson & Johnson's, also could help with supply shortages if authorized, health officials said.

"I know the Biden administration is going to intensify production," de Blasio said. "I have faith that the weeks ahead, we're going to see a whole different level of production of the vaccine happening."

Ferrer urged patience, saying that with a new federal administration, "We expect our situation to improve greatly."

For now, Adalja recommended that people continue to be "tenacious" about getting appointments if they're eligible, as the longer people go unvaccinated, the more time the virus has to spread.

"It's unfortunate that it's come to this," he said. "It shouldn't be this hard to get a vaccine."

Copyright © 2021, ABC Audio. All rights reserved.

Mom speaks out as healthy 15-year-old daughter contracts COVID-19

Christina Meredith By NICOLE PELLETIERE, ABC News

(NEW YORK) -- A Texas mother is sharing the story of her teenager's ongoing fight against COVID-19, in hopes to remind parents that young people are still at risk.

Christina Meredith, a resident of Kyle, Texas, told ABC News' Good Morning America that her 15-year-old daughter Katelynn Rodriquez, is still showing symptoms of the coronavirus after being hospitalized late last month.

Meredith said Katelynn is an active cheerleader, volleyball player and runner with no pre-existing health conditions.

"Katelynn wants to tell people to wear their mask and let them know that kids get sick," Meredith told Good Morning America. "Her main thing is it doesn't discriminate. It doesn't matter your age or gender."

Katelynn is a high school sophomore. Her family suspects she was exposed to COVID-19 in December from a fellow student.

Meredith said Katelynn tested positive for COVID-19 on Dec. 22. She experienced an itchy throat, runny nose and a fever of 105 degrees.

"On Dec. 28, I woke up and had to go to work that day," said Meredith, who is a certified nursing assistant. "I peeked in to check on her...she said, 'I can't breathe.' We were on day 10 so I was hoping this fever would break."

Meredith and her husband brought Katelynn to a local hospital, where an X-ray revealed she had pneumonia. Doctors told Meredith that she could bring her daughter home so long as her oxygen remains in the 90s level.

Meredith said that in 2012, she lost another daughter, Katelynn's sister, to the genetic lung disease cystic fibrosis and wasn't taking any chances.

"I was terrified. ...I work in the nursing field and I knew what could happen next," she said. "It was very hard for me but I had to hold it together for Katelynn. I think she looked for me for the strength, so I just held my composure. Deep down inside, I was thinking the worst."

Katelynn was then brought to Dell Children's Medical Center in Austin, Texas, where she was admitted for 13 days. There were talks of intubation, though Meredith said doctors never got that far.

She received medication for inflammation and high flow nasal cannula. Katelynn was also given the drug remdesivir, which is an antiviral med intended to treat COVID-19. She and her parents agreed to participate in a study so medical teams could learn more about administering the drug to pediatric patients hospitalized for COVID-19 without any underlying symptoms, Meredith said.

Katelynn was sent home on Jan. 8. Meredith said she is still experiencing headaches, tingling in her legs, bedwetting and fatigue. She is currently taking blood thinners and is beginning physical and occupational therapy.

Jay D. Bhatt, an ABC News medical contributor and Chicago-based primary care physician told GMA that little-known symptoms such as bed-wetting could be a complication of long-term COVID-19 exposure.

"We're learning every day of new symptoms that emerge," Bhatt said, adding that there's a long list of post-COVID symptoms.

Meredith said she and Katelynn would like to raise awareness on how young people can still contract COVID-19.

Bhatt echoed this.

"It finds infectious pathways through the nose and treats people the same, so if you're in the path of the virus, you're at risk of getting it," Bhatt said.

"We've seen completely healthy people be exposed to the virus and have severe consequences including death," he added. "We've seen people active and athletic who may have more of an ability to fight the virus if they're infected, but it doesn't keep them having severe symptoms."

Bhatt and Meredith reminded the public should keep taking health precautions to stay safe.

Meredith said she wants to thank her community and Katelynn's cheer team for launching the GoFundMe page, which will help the family cover medical bills.

As Katelynn recovers, her teammates have made signs reading "Kat Strong" and hold them at sporting events in her honor.

Copyright © 2021, ABC Audio. All rights reserved.

This 81-year-old TikTok influencer is all the fitness inspiration we need

mlleelizabethart/iStockBy GMA TEAM, ABC News

(NEW YORK) -- Erika Rischko is an 81-year-old mother of two, grandmother of one and, surprising to even herself, a fitness influencer.

Rischko, of Langenfeld, Germany, describes herself as a "late bloomer" when it comes to fitness, but she now is inspiring people decades her junior with the workouts she shares on TikTok and Instagram.

"I am really honored and humbled that younger people are being inspired by me," Rischko told ABC News' Good Morning America. "I love comments such as, 'You are so inspiring, life goals, couple goals, can you be my grandparents?'"

"If I can change the stereotype of old people being boring or not being active just a bit, that makes me very happy," she said.

Rischko, a homemaker, said she did not start regularly exercising until her mid-50s when her daughter signed her up at a local gym.

"As both kids were out of the house for the first time, I was lonely," Rischko said. "The first five years, I was not as 'addicted.' Then, I slowly started to do more and even joined some three to four-hour spin class challenges and rowing competitions."

More than 20 years later, Rischko said she works out twice a day, several days a week.

"My husband, who is also 81-years-old, goes to the gym with me during the week in the morning, but we do not train together," she said, adding that she usually bikes to and from the gym so her husband doesn't have to wait on her. "During the week, I also work out three to four times in the evening for an hour."

Rischko said she joined Instagram in February at the urging of her daughter, who wanted her to share her workouts with family and friends.

When the coronavirus pandemic closed gyms last spring, Rischko then started taking part in fitness challenges on Instagram.

"The response was just overwhelmingly positive, which I have found very uplifting as I have been very insecure all my life," she said. "And then my daughter discovered TikTok as some of the dance challenges were being featured on German TV and the app became very popular during the pandemic."

Rischko started taking part in some of the fitness challenges on TikTok and quickly developed a following. Her videos on the social media app now have more than two million likes.

 I would have never expected to get this many uplifting comments and followers," said Rischko, adding that her daughter helps her film and post her workout videos. "Both apps [Instagram and TikTok] have helped me to stay up to date with technology and what the younger generations are up to these days."

When it comes to her workouts, Rischko said she is always trying something different, a piece of advice she gives to her younger followers.

"I mix it up all the time, so that I get a different intensity and/or duration," she said. "It is important to change your workout routine to get stronger and not waste your time."

In addition to her active lifestyle, Rischko also credits her longevity to eating fresh foods, but not counting calories, rarely drinking alcohol and giving up smoking 30 years ago.

"I think my advice is fairly simple: Do not do anything extreme - there is no need to -- and start slowly," said Rischko. "Just eat healthy, but do not chastise yourself."

"And figure out what works for you," she added. "Find a sports activity that you enjoy because if you do not enjoy it you will not last, and if you are not as disciplined as I am, find a workout partner as it is not that easy to cancel on somebody."

Rischko's final advice is to start being active now.

"I just wish I had started even earlier, before I turned 55," she said.

Copyright © 2021, ABC Audio. All rights reserved.

The COVID-19 challenge Biden faces on Day One as president

vchal/iStockBy ERIN SCHUMAKER, ABC News

(NEW YORK) -- When President-elect Joe Biden is sworn in on Jan. 20, he'll be inheriting more than the Oval Office. As the COVID-19 pandemic extends into another year, the United States is leading the world for all the wrong reasons.

With more than 24 million infections, the U.S. has reported more than twice as many COVID-19 cases as India, the second leading country with four times the population, and tragically, more than 401,000 deaths. That's more virus-related fatalities than any other nation on Earth, according to data from Johns Hopkins University, and exceeds the number of U.S. soldiers who died in battle during World War I, World War II and Vietnam combined, according to a data estimate compiled by the Department of Veterans Affairs.

The U.S. is also in the midst of the biggest surge of the pandemic to date, with 10 states reporting record numbers of new deaths this week, according to an ABC News analysis of data from The COVID Tracking Project.

To fight what some call the world's worst outbreak, the U.S., under the Trump administration's Operation Warp Speed has responded by wielding scientific and financial resources to develop two 95% effective COVID-19 vaccines, produced by Pfizer and Moderna, in record time.

"The good news and what’s in Biden's favor, is that we have some really great vaccines and more on the horizon," said Courtney Gidengil, a senior physician policy researcher at RAND.

But in addition to inheriting the vaccines themselves, Biden is inheriting the logistical challenge of getting those shots into millions of Americans' arms -- specifically enough to begin cutting down the infection rate as new and more transmissible variants of the virus spread.

"Operation Ward Speed achieved getting the vaccine up and running, but we never had an actual vaccination strategy to go with it," Gidengil said.

Instead, the federal government outsourced vaccine distributions to the states, she explained, who in turn pushed the responsibility on local health departments and ultimately on hospitals, which were already overburdened by treating COVID patients.

With no clear strategy in place, the Trump administration fell short of its goal of getting 20 million Americans vaccinated by the end of 2020. Instead, as the sun set on the Trump presidency, less than 13 million of the 31 million doses distributed so far had made it into Americans' arms, according to the Centers for Disease Control Prevention.

Biden spoke to the daunting task ahead during news conference last Friday in which he laid out a five-point plan to speed up vaccine distribution.

"This will be one of the most challenging operational efforts ever undertaken by our country," Biden said. "You have my word that we will manage the hell out of this operation."

Still, bumps in the road are expected, experts say. Beyond the high number of infections, hospitalizations, deaths and the missed vaccination goals is a set of interrelated obstacles that the Biden administration will inherit.

Here's what experts say Biden's key COVID-19 challenges are:

Underfunded public health infrastructure

According to Dr. Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security, one of Biden's biggest and most enduring challenges didn't start with the Trump administration.

"It’s important to remember that even if everything went perfectly with vaccine rollout, we’re still dealing with a public health system that's been underfunded and undervalued for so long," Adalja pointed out. "No matter who is in charge, it's really hard to turn something like that around."

Instead of investing in public health as a national security priority, the United States is caught in a cycle of panic and neglect, funding efforts to battle past infectious disease outbreaks, like Zika, MERS, SARS and Ebola, in moments of acute crisis and then pulling public health funding once immediate danger subsides.

"When something recedes from the headlines it also recedes from priority," Adalja said. "The challenge will be building a sustainable system that’s not just for COVID."

Politicization of the pandemic and public health experts

While past infectious disease outbreaks, such as Ebola, H1N1 and the 1918 flu have been politicized, according to Adalja, none has been as politically charged as COVID-19.

"A large proportion of the population have utter and complete distrust of public health authorities," Adalja said.

Once among the most trusted health agencies in the world, the reputation of the Centers for Disease Control and Prevention is in tatters after a botched testing rollout early in the pandemic and a Politico investigation that found Trump officials interfered with the agency's Morbidity and Mortality Weekly Reports.

The Trump administration's refusal to wear masks and refrain from indoor gatherings became a sticking point for members of the White House coronavirus task force, who tried to encourage the public to adhere to COVID-19 mitigation measures even as members of the administration flouted them.

In some cases, distrust has jeopardized health officials' personal safety. Dr. Anthony Fauci, as well as less well-known public health officials, have been targeted, harassed and even received death threats from anti-mask opponents. Some were pushed to the point that they resigned.

Restoring lost trust won't be easy for the CDC.

"They are starting to get their courage back post-election, but a lot of damage has been done," Adalja said.

While White House coronavirus briefings during the Trump administration tended to feature Trump himself, experts recommend that the Biden administration let scientists take center stage, which Biden has already pledged to do.

Experts like the surgeon general will speak directly to the American people, Biden said Friday and promised to be transparent about "both the good news and the bad," when it came COVID-19 progress.

"You’re entitled to know," he said.

In addition to allowing CDC and FDA experts to airtime, Dr. Eric Toner, a senior scholar at Johns Hopkins Center for Health Security, recommended that the president and senior staff give daily encouragement to the public about stopping COVID-19's spread.

Faced with inheriting "a substantial portion of the populace that doesn’t believe in the pandemic or the vaccine," Biden needs a diverse national campaign to promote vaccination, Toner added, "including voices that resonate and are likely to be trusted by different segments of society."

In addition to making special efforts to reach historically discriminated against groups, "sophisticated, well-informed communication is key to go head to head with antivax organizations and convince youth who feel invincible to vaccinate themselves as an altruistic act," according to Cheryl Healton, dean at NYU's School of Global Public Health.

The U.S. bet it all on vaccines

In focusing narrowly on Operation Warp Speed, the Trump administration left only one option for escaping the pandemic: vaccination.

Other countries, such as Singapore and Taiwan, invested heavily in COVID-19 testing and contact tracing to control disease spread. But with largely unchecked community transmission in the U.S., that's no longer a viable mitigation option.

"The U.S. will never be Singapore or Taiwan," Adalja said. "That die was cast last year."

Other experts lamented lack of coordination in the current COVID strategy. The U.S. still doesn't have adequate testing or PPE, they said. Unlike the United Kingdom and South Africa, the U.S. has no national testing surveillance system to detect new virus variants. Instead, some states do rigorous surveillance, while others don't.

Given that the new variants first identified in the U.K. and South Africa are thought to be more transmissible than the old variant, not being able to actively check for emerging variants, "is definitely a sobering thought," Gidengil said.

Healton would like to see Biden's plan go further than what he's outlined so far. She urged the administration to try to obtain a court order to mandate public use of masks.

"It would be a heavy lift, but as things stand now we are allowing people to infect others routinely and what state you live in determines your risk," Healton said.

Among the dozens of executive orders Biden plans to sign on inauguration day is a 100-day national mask mandate, which will be enforced on all federal property and during interstate travel on planes, buses and trains. He's also promised to tap the Federal Emergency Management Agency (FEMA) to set up federally funded mass vaccination centers in school gyms and sports stadiums to ramp up vaccine distribution and to use mobile clinics to help reach hard-hit communities.

While experts acknowledged that the jury is still out on whether the Biden administration will be able execute and fund his big-picture COVID strategy -- the details are important, they agreed -- ultimately they're hopeful.

"Much of what’s in his plan for the pandemic are things people in my field have been advocating for a year now," Adalja said.

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