ABC - Health News

Prince Williams/WireimageBy DEENA ZARU, ABC News

(CHICAGO) -- By the time he was in the sixth grade, G Herbo had already started losing friends to gun violence and according to the Chicago rapper, for communities that deal with the brunt of the violence, the city has become a “mental illness war zone.”

The 24 year-old hip-hop artist, whose full name is Herbert Randall Wright III, has lost dozens of friends to gun violence and has reflected on the pain and loss in his music over the years.

In his latest album "PTSD," which was rereleased Friday with a cover to mark Mental Health Awareness Month, the rapper reflects on his own struggles with post-traumatic stress disorder -- a condition he realized he was dealing with after seeing a therapist about two years ago.

TUNE IN IF YOU EXCITED WE LISTENING EARLY IN THE APP 👉 https://t.co/hStOucmVtu#PTSDDELUXE pic.twitter.com/Ssmqz14bJI

— G HERBO (@gherbo) May 28, 2020

“The album being called PTSD is because I walk around everything with post traumatic stress disorder. I come from the streets, I come from not knowing if you’re going to make it home and being okay with it,” G Herbo told ABC News, adding that the majority of people in his community who experience gun violence “are walking around with this illness” and “we don't we don't even realize it.”

Karen Sheehan, the medical director of Strengthening Chicago’s Youth which seeks a public health approach to addressing gun violence, told ABC News that “social isolation” in a segregated city has led to the “normalization of violence” and the trauma it causes.

“We often talk about PTSD that you’ve had this one bad experience and it’s hard to recover. The problem is it’s never relenting, it’s gone on for generations. That’s more challenging because there isn’t a place for safety to come home,” Sheehan said.

“... For our poor young people and families in Chicago there isn’t any time you can ever escape. I can’t imagine how that unrelenting experience of repeated trauma wears on them and that makes it a much more difficult problem to solve.”

Even amid the stay-at-home order due to the coronavirus pandemic, gun violence is still on the rise in Chicago.

According to a 2019 report
by the Erikson Institute, a graduate school in child development in Chicago, “the majority of Chicago’s youngest children live in communities with high homicide rates, increasing the likelihood of an adverse impact on their early development due to environmental trauma.”

G Herbo said that by opening up about PTSD on his album, he wanted to encourage others to “lean towards your fears to make your situation better so you can understand the reality of what we’re going through.”

The rapper’s hope of helping others in his community is already resonating.

Dr. Jaleel Abdul-Adil, a clinical psychologist and the Co-Director of the Urban Youth Trauma Center at the University of Illinois in Chicago, has been infusing traditional therapy methods with hip-hop for thirty years in an effort to connect with young people and when PTSD was first released in February, it immediately caught his attention.

“When PTSD first came out, it immediately jumped out … especially when you’re working with trauma programs, how can you not?” Abdul-Adil said.

The chorus of album’s title track "PTSD," which features Chance the Rapper, Juice WRLD & Lil Uzi Vert, begins with this: “I got a war zone inside of my head/ I made it on my own, they said I'd be in jail or dead/ I've seen my brothers fall, over and over again/ Don't stand too close to me, I got PTSD.”

Abdul-Adil, who trains mental health providers and caretakers around the country to utilize hip-hop to connect with children, said that he first used G Herbo’s music in his sessions when the rapper released “Red Snow” in 2017 -- a somber and evocative song about a particularly deadly winter in Chicago following a rash of shootings.

He said that although music “doesn't solve all the problems,” “it can certainly inspire you to think, behave, connect and begin to try to address your problems much better than the traditional means that often don't engage youth.”

“So what I do is I take the traditional programs, which are based on research and employ social sciences that are based on best practices, but I kind of season them, if you will, with rap music and hip hop language, examples and different things so that kids can hear what we're saying,” he added.

When told in a later interview that his music is being used in therapy sessions, G Herbo said “it feels great” to know that his songs are generating a conversation about mental health.

“That's the reason I do music -- one of the reasons -- to be able to help people because my music is a reflection of my life and the things that I’ve been through. I use it as a form of therapy to help me get through situations.”

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beerkoff/iStockBy DR. JAY BHATT, OLIVIA RUBIN, DR. MARK ABDELMALEK, MATTHEW MOSK and EDEN DAVID, ABC News

(NEW YORK) -- If a second wave of the novel coronavirus emerges in the U.S. this fall, medical experts said patients arriving in American emergency rooms will likely have an entirely different experience than what urgently sick patients saw earlier this year -- the benefit of hard-learned lessons from the deadly disease.

“If there is a second wave in September, we will be protecting our patients and our staff in better ways, and will have the knowledge of the first wave to guide us in the best ways to treat patients,” said Dr. Bill Jaquis, president of the American College of Emergency Physicians.

Richard M. Schwartzstein, who heads pulmonary and critical care at Beth Israel Deaconess Medical Center in Boston, predicts there will be less anecdotal medicine and more evidence-based care than the first time around.

“The difference now is that these options are better refined and being studied more carefully,” Schwartzstein said. “Care is more rational with less sense of desperation.”

There is still no way to know whether COVID-19 cases will surge in the fall, as some have predicted. And it remains unclear if the U.S. could face a serious risk of hospitals being overwhelmed with patients if the outbreak roars back to life.

But public health officials said they do believe there has been a marked evolution from the chaotic early days of the coronavirus pandemic. And they say that even facilities that haven't been directly hit by the virus' first wave will have people to turn to, information available that wasn't before, and time to put surge plans in place.

As with most everything, practice helps. As of this report, the U.S. has seen more than 1.7 million cases of COVID-19 and more than 101,000 deaths. From that grim experience, hospitals have, through repetition and careful study, refined everything from the choice of early medications to the methods they use to position patients in bed, where doctors hope they'll be treated with powerful new therapies.

With more understanding, better preparation, better methods

One of the most challenging aspects of treating the outbreak was that it emerged quickly, before most hospitals could truly prepare.

Hospitals scrambled to scale up their supplies to meet the sudden and desperate need. At certain points nurses were asked to ration their use of critical gear -- storing their one respirator mask per day in a brown paper bag.

Dr. Josh Sharfstein, former state public health official and assistant dean at Bloomberg School of Public Health, told ABC News hospitals now have a better sense of their needs. To prepare for any surge, he said hospitals will be ordering large reserves of protective gear, and they will have designed plans to increase intensive care and ventilator capacity.

“The health care system was largely taken by surprise in the spring,” Sharfstein said. “It’s everyone’s shared responsibility to prevent a repeat in the fall.”

When patients started arriving in those early days, doctors were laying eyes on the novel coronavirus and its bizarre array of symptoms for the first time. Now many have strategies in place.

Health care experts realized, for instance, that they needed to check patients arriving at hospitals for early signs of blood clots, which has emerged as a common hallmark of a dangerous COVID-19 infection.

Caregivers have also found benefits of rolling even mildly ill coronavirus patients on their stomachs, finding that using prone positioning eases the stress on fluid-filled lungs.

And physicians have honed their ability to recognize the needs of patients with more serious infections.

“We understand better how to manage these patients on mechanical ventilators and the time it takes for many of them to improve,” Schwartzstein said.

Fine tuning medications

When it comes to drug treatment, health care officials said they have seen how some medications are in greater demand, such as Remdesivir, which proved helpful in reducing hospital stays for those with advanced cases of the illness during early testing.

Production of the drug is ramping up, and Health and Human Services Secretary Alex Azar told governors this week that, as of Saturday, initial shipments have now reached every American state and territory.

Azar told the state officials he had “more good news”: the company Gilead, which manufactures Remdesivir, agreed to donate an additional 333,000 vials to the U.S. government, bring the total to 940,000 vials -- enough to treat approximately 120,000 patients.

Other medications that attracted early interest in intensive care units have been set aside in many cases. Schwartzstein told ABC News medical centers in Boston had halted the use of hydroxychloroquine.

The once-promising drug had shown early signs of success in China, and been championed by President Donald Trump from the White House podium. But last week, the scientific journal Lancet published results from a 96,000-patient observational study that concluded that hydroxychloroquine had no effect on Covid-19 and may have even caused some harm.

"The scientific data is really quite evident now about the lack of efficacy," Dr.Anthony Fauci, the Trump administration official helping lead the pandemic response, told CNN.

Plasma, antibodies show promise

As pharmaceutical companies and public health researchers toil in labs in search of additional medications, many believe even more effective treatments for those who come down with COVID-19 will be on hand at American hospitals come fall -- even if a vaccine is still months away.

Azar told governors he sees a bright future for the various approaches doctors will use when confronting the virus in the months to come.

“On therapeutics, we continue to advance three strategies,” Azar said.

The first, he said, is the use of convalescent plasma, collected when someone who has recovered has donated their blood. The blood is then separated into plasma that contains virus-fighting antibodies that can be used for others who are sick.

It’s one of the few treatments showing early indications that it can help. Back in March, only a small number of facilities were able to perform convalescent plasma treatments. But in just three months, the treatment is now an option at over 2,300 hospitals across the country, according to the COVID-19 expanded access program.

Dr. Michael Joyner, an anesthesiologist at the Mayo Clinic, said experts are currently working on plans for how best to collect and distribute convalescent plasma if a second wave hits this fall.

“Where we are in the fall depends,” he said. If more evidence emerges showing the treatment is effective, he expects it to be more widely used.

The second strategy, Azar said, involves the use of what he called “hyper immunoglobulin,” which he said basically involves commercially processing plasma donations from multiple people to create a more consistent and powerful antibody treatment.

"You're giving thousands or millions of antibodies, but the problem is that once you need another dose you need to bleed more people and start over again,” explained Dr. James E. Crowe, who serves as the director of Vanderbilt Vaccine Center. "Hyper immunoglobulin" treatment with standardized serum could be more effective on a mass scale.

Transferring antibodies from recovered patients to those who are actively infected is not fool-proof, though. Since everyone's antibody production following infection can slightly differ, researchers try to identify ideal donor candidates -- those with the highest levels of neutralizing antibodies.

The technique, Crowe said, is an “old school” method, but “might well be the first antibody [treatment] we see used.”

With new therapies, a bridge to a vaccine?


Azar said the third strategy he expects to see widely deployed involves antibodies that are actually themselves produced outside of humans, what are known as monoclonal antibodies.

“We've got over 20 companies with monoclonal antibodies in development and working on prioritizing and focusing our development efforts and manufacturing capacities on those,” he said.

This approach -- similar to hyper immunoglobulin therapy -- is meant to simulate or mimic the antibodies made in your own body.

"Basically we can move immunity from one person to another and the person who receives it has instant immunity," said Crowe.

Crowe said this method is preferred over-hyper immunoglobulin therapy "because it's reproducible and much better defined."

But historically, it has been a more expensive approach because of the extensive process required to produce and purify the antibodies on such a large scale. Moreover, the benefits don’t last very long -- typically around 90 days -- so the value of these drugs is limited.

Still, if there was a viral surge that sent patients to the emergency room in the fall, there are indications that these drugs could be on hand, with some hope it could help halt disease progression.

At the Duke University Human Vaccine Institute in North Carolina, scientists are already developing a monoclonal antibody treatment that can be bottled and shipped out. Dr. Gregory Sempowski, the director of the Regional Biocontainment Laboratory at the Institute, called the potential treatment "a next-generation version of convalescent plasma."

Duke is one of four locations across the country working on this treatment. Their efforts have been financed by the Defense Advanced Research Projects Agency (DARPA), the nation’s premier military lab. Pharmaceutical companies are also in the hunt. One firm, Regeneron, has indicated it is just weeks away from starting clinical trials.

Crowe predicts that monoclonal antibody treatment will become available before vaccines -- as early as the end of this year or early 2021.

"Most people think of antibodies as a bridge because they give us immunity for a period of time until vaccines are ready," said Crowe.

But ultimately, a vaccine, if proven safe and effective, is still the endgame for the viral battle, experts said.

"When you're vaccinated, your body makes antibodies. It's like a factory that doesn't turn off,” Crowe said. “The durability and duration of immunity with vaccines is longer."

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George Floyd is pictured in an undated photo. (Courtesy Ben Crump Law)By AVERI HARPER, ABC News

(NEW YORK) -- For many black men, viral videos featuring the killings of other black men can weigh heavily. Watching the disturbing footage can impact the mental health of African American men, experts say.

For civil rights advocate and Georgetown Law Center professor Preston Mitchem, the images can lead to physical symptoms.

"My stomach is in knots, my heart is racing, my brain is pounding and none of that is hyperbolic, said Mitchem. "It is exhausting to think that you can be up next."

New York City Public Advocate Jumaane Williams offered a tearful statement during a press conference Wednesday. Though he couldn't bring himself to view the most recent killings, Williams said he was "not okay."

"I am tired," said Williams. "I have yet to watch the video of Ahmaud Arbery. It's too much. I have not watched the video of George Floyd. It's too much."

For others, the videos conjure mixed emotions like anger, despair and powerlessness.

"It hurts, but then also you're feeling anger, and then you have a feeling of helplessness, because, what can we do?" said Rwenshaun Miller, a Charlotte, North Carolina, psychotherapist and founder of the nonprofit Eustress, Inc. that aims to improve mental health in black communities.

Video of Ahmaud Arbery, the Georgia man who was shot by a father and son while jogging in February, and George Floyd, the black man who died after a Minneapolis police officer kneeled on his neck, are the latest incidents capturing the brutalization of black men. The trauma collectively experienced by the black community in the wake of the incidents dates much further back.

"Being shown and seeing images that really demonstrate violence on the black body is something that is not only traumatizing from a contemporary perspective but it also has historical trauma. It really does sort of play to these like larger issues that have been with us for hundreds of years," said Martine Hackett, a public health professor at Hofstra University.

The beating and mutilation of slaves as punishment was accepted practice by slave owners. Late into the 20th century, the threat of lynching in the South was commonplace. Following the 1955 torture and murder of Emmett Till, a 14-year-old boy killed by two white men in Mississippi, pictures of his unrecognizable, mutilated body were published. The images of Till's remains are widely considered a flashpoint that ushered in the Civil Rights movement of the 1960s.

According to health experts, repeated viewing of these images can trigger mental health conditions and impact overall health.

"We can experience PTSD, we can experience other mental health challenges as well anxiety, depression, all of these things may be a result of how we're in the world and as these images continue to circulate," said Miller. "That added stress, the trauma and the constant worry will weigh on you very heavily. It's similar to living in a war zone."

"The stress of viewing these disturbing images has a physical manifestation. Often times, people will say, 'this makes me sick to my stomach' or 'I feel like I'm gonna choke' and those are really, those are actually legitimate feelings that you are having," said Hackett. "And the truth is, that's one of the first things is to recognize that these stressors do play a role in our physical health."

Mitchum says that COVID-19 has only complicated the ways in which he and other black men would normally cope.

"Usually there's some kind of way for us to actually find joy, hanging out with your friends, engaging with your family, being able to experience a physical touch that's rooted in like love and affirmation, that's something that many of us are being denied because of COVID," said Mitchum.

Miller recommends taking a timeout from consuming media to alleviate the feeling of bombardment by these violent images.

"The first thing we do is pick up our phone and start to scroll and that's all you're seeing. So I would suggest that people take a break from the news, take a break from the (social media) feeds," said Miller. "You got to give yourself a break."

He suggests finding other outlets like talking to someone you trust, journaling, coloring or exercising to cope. He also encourages men to consider seeking therapy.

"Find ways to introduce self-care into your daily lifestyle, we can't wait until a traumatic event occurs and then we want to try to fix our mental health or take care of our mental health. We need to be proactive in doing these things," he said.

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ABC News(NEW YORK) -- BY: DR. ANGELA BALDWIN

As doctors and scientists continue to learn more about the novel coronavirus, researchers are laboring to figure out exactly who is the most susceptible to the virus. One vulnerable group that has not yet been extensively researched is people with cancer -- but a new study is helping to change that.

Cancer patients face specific circumstances that may place them at higher risk for severe COVID-19 symptoms. Their immune systems may be weakened by anti-cancer treatment, additional supportive medications like steroids, and by cancer itself.

Unfortunately, cancer patients are also frequently older and have other underlying health conditions, putting them at additional risk for severe coronavirus symptoms. But there aren't many studies describing the fate of people with cancer who also develop COVID-19.

"As oncologists we are accustomed to dealing with infectious complications, but the challenge with COVID-19 is that there is no specific treatment available at the time," said Dr. Wasif M. Saif, M.D., deputy physician-in-chief and medical director at Northwell Health Cancer Institute in Lake Success, New York.

It's a tricky situation as doctors must balance the risk of treating the cancer -- knowing it could put the patient at risk for worse COVID-19 symptoms or death -- versus delaying cancer treatment, which could allow the cancer to progress, resulting in worse cancer symptoms or death. In order to make the best decision, doctors needed more information.

Consequently, researchers from multiple institutions reviewed the records of more than 1,000 adult patients with cancer and confirmed COVID-19. The records were collected and cataloged by the COVID-19 and Cancer Consortium registry, a collaboration between academic and community oncology specialists in the United States and Canada. They investigated the association between numerous variables and death within 30 days of COVID-19 diagnosis. By the end of the study, 13% of the patients had died.

"The 30-day all-cause mortality was 13%, more than twice the mortality reported as the global average by Johns Hopkins," explained the co-lead author of the study, Dr. Toni K. Choueiri, director of the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute.

According to the study, if you're living with cancer, COVID-19 may be more dangerous for you than the average person. That means cancer patients should speak with their doctor about the risks of continuing treatment.

The researchers found several factors associated with an increased risk of death: older age, male sex, previous smoking history, having two underlying health conditions, active cancer, and treatment with azithromycin plus hydroxychloroquine. Of note, the researchers said they could not tell if hydroxychloroquine plus azithromycin gives any benefit or overall harm to the patients, because the study was not set up to look at that question, nor did it account for other potential variables.

Interestingly, race and ethnicity, obesity status, cancer type, type of anticancer therapy and recent surgery were not associated with increased death.

These important findings will guide oncologists in treating their patients during this pandemic.

"Taken together, these results suggest that fit patients with cancer and few comorbidities can and should proceed with appropriate anti-cancer treatment," noted Choueiri, "whereas those with poor performance status or progressing cancer need to have thoughtful conversations with their oncology providers about risk versus benefit of anti-cancer treatment."

There is no doubt that the COVID-19 pandemic has placed cancer patients at a higher risk. But progress is being made on determining how to best protect these vulnerable patients.

"We are already at more than 2000 patients in our database and accumulating more granular data about specific therapies to be able to answer important questions relevant to patients with cancer," Choueiri said.

The only way forward is with continued rigorous scientific study, experts say.

"Until the pandemic has ended, we have to rely upon the principles of safety and evidence-based piers of priority in individualizing patients care," said Saif. "The fluidity of the situation mandates us to adapt and modify as we learn more about this disease and its impact."

Angela N. Baldwin, M.D., M.P.H., is a pathology resident at Montefiore Health System in the Bronx and a contributor to the ABC News Medical Unit.

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ABC NewsBy DEVIN DWYER, ABC News

(NEW YORK) -- For Meredith Minister, this was supposed to be a summer of living it up and dancing away fears of late-stage metastatic cancer.

"I am in a place with cancer where I am just trying to make decisions to live my life as long as it lasts, and not trying to lengthen my life by decreasing its quality," said Minister, 36, a religious studies professor and amateur dance enthusiast, who is no longer receiving treatment for her disease.

"The way that I could exchange energy with other people on the dance floor -- those are not things that you can approximate virtually," she said.

Many of the 15 million Americans living with cancer are coming to terms with a pandemic that has upended support systems and coping mechanisms, facing difficult choices about how to live fully in the era of social distance.

For some, deferred care and missed diagnoses during the nationwide public health lockdowns have also added up to precious lost time and deep anxiety over the future.

That's on top of worry about the coronavirus itself.

"I'm obsessed with thinking about the coronavirus. I'm obsessed with, 'Am I going to get it? Is my family exposed? Are we doing things that stay safe?'" said Kacie Peters, 33, of Denver, who was diagnosed with stage 3 colon cancer earlier this year and recently completed chemotherapy.

"It's frustrating that a lot of folks are jogging and strolling without masks. There are plenty with them. But, it's a really weird feeling that people are dangerous," she said of her community as it begins to reopen.

Cancer patients, especially those actively undergoing treatment, have compromised immune systems that make them more susceptible to infection. Some say their disease has prepared them for the daily precautions that have become more widely adopted during the outbreak.

"We kind of live in a pandemic daily," said Bruce DeArk, a deputy fire chief in Jeffersonville, Indiana, battling stage 4 colon cancer. "Truthfully, if your immune system's compromised every day, you should have a mask on or you shouldn't go to stores where there are lots of people. But, this is the unseen enemy that you can't see. So it's kind of -- kind of scary."

Fear of the novel coronavirus has given way to an emotional dilemma, some cancer patients say: Get treatment and risk contracting COVID-19 at the hospital or stay home and wonder about lost time.

DeArk decided to postpone a spring trip to a top cancer clinic in Texas in light of the risk. In April, Peters made the difficult call to put off her next course of chemotherapy because Colorado was seeing a surge in coronavirus cases.

"If in five or 10 years, I have a resurgence of cancer, maybe it was because I didn't do that chemo," Peters said.

Breast cancer survivor Dawn Buckner of Adair, Oklahoma, said she's feared most for her children -- a son with asthma and daughter with cerebral palsy. Last month, just weeks before her final breast surgery, she got hit with COVID-19 herself.

"I called my husband. I was bawling, and I'm like, 'You've got to get, you know, my son, out of the bedroom,'" she said. "You see the worst of it on TV and you think, 'Oh my gosh, am I gonna stop breathing here in a minute?' So, I was pretty frantic the first day."

Buckner was forced to isolate herself at home, leaving her husband to run their small business and care for both kids. She prayed her fragile immune system would handle the disease.

"I have cancer, but I can tell you right now a whole list of people I know that that are worse off, whether it's cerebral palsy, whether it's cancer. There is always -- always -- somebody worse off than what you are," Buckner said of her outlook.

There is also the fear of dying alone, some cancer patients said, as hospitals limit bedside visits during the outbreak.

"That's terrifying to me because that's not how I want to die," said Minister. "It's a very real fear. And you plan for it the best that you can. There's not a solution."

Nearly two million Americans will be newly diagnosed with cancer this year, according to the National Cancer Institute. Over the last three decades, the annual number of cancer diagnoses and deaths have been steadily on the decline. But experts say the pandemic could turn those trends around.

"Screening and prevention and treatment are the pillars of medical care, and when you prolong that time, regardless of the chronic disease you're talking about, the worse the outcomes are going to be," said John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News medical contributor.

"I'm getting very worried," Dr. Ned Sharpless, director of the National Cancer Institute, told the agency's board during remarks this month. "Because of the pandemic, in 2021 or 2022 or 2023, we will have (the first report) since 1993 that shows an increase in cancer mortality. And I know exactly what the statistics will mean for patients: That represents more cancer suffering."

The scientific community also fears what a report in next month's The Lancet Haematology journal describes as the pandemic's "serious and disruptive effect" on clinical trials for cancer treatments and potential cures.

"The apparatus of research, other than computer-based analyses, has really come to a grinding halt in most parts of this country," said Brownstein. "So if you think about medical research as an engine that helps us develop therapeutics, then you have a gap in the pipeline."

For many cancer patients, the focus now is less on the future and more on the present.

"It's a mental challenge," said DeArk. "I've never been what you want to call scared. I've been more or less anxious, because I've taken this head-on since day one. This is not going to beat me. It's not going to define me."

Peters said the quarantine experience is an opportunity for reflection.

"It's those little victories of every day of just saying like, 'Hey, I didn't die today.' And, 'hey, the world still exists outside my window,'" she said.

Buckner, battling the coronavirus and breast cancer, said the double whammy of diseases requires daily acts of courage. Last week, she drove two hours by herself to get re-tested for the "all-clear."

This week she's celebrating her results: negative for COVID-19 and moving forward with one last planned surgery next month.

"We are thinking about how we want to live, and how we want to live better, and how we want to live with others better, which I think the pandemic, even more than cancer, is inviting us to think about right now," said Minister.

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ABC NewsBy GMA Team, ABC News

(NEW YORK) -- Vivian King was 49 years old when she suffered a massive stroke.

"I was in neurological ICU for 10 days and the hospital for a total of 32 days," King, a former TV news anchor in Milwaukee, Wisconsin, told Good Morning America. "That was a huge shock for me."

King said her stroke seven years ago was caused by a blood clot in her brain that she said was caused by her use of birth control.

"When you look at the list of stroke risks, [you see] high blood pressure, high cholesterol, obesity, but you don't really get to birth control until the final list," added King, who has made it her mission to educate women about stroke risks. "Women have said [to me], 'As soon as that happened to you, I went to go talk to my doctor about it.'"

The blood clot affected the left side of King's brain, which she said left her unable to speak for nearly four weeks.

King, now recovered, is sharing her story in a new memoir, "When the Words Suddenly Stopped." In it, she opens up about how she found her voice again and sharing her three-step guide to healing.

"We're going to call it the three P's. You need a posse, you need persistence and you need prayer," she said. "Any time I was feeling down, I had my posse around to give me hope."

What women need to know about the risk of strokes


One in five women in the U.S. will have a stroke in their lifetime and stroke is the fourth-leading cause of death for women, according to the Centers for Disease Control and Prevention (CDC).

The leading causes of stroke for all people include risk factors like high blood pressure, high cholesterol, smoking, obesity and diabetes, according to the CDC.

For women, there are additional unique risk factors to watch out for, as King's stroke shows.

"Women have unique stroke risk factors and oral contraceptive use is one of them,” said Dr. Carolyn Brockington, director of the Stroke Center at Mount Sinai West and Mount Sinai Morningside in New York City. “It’s very important to know.”

When it comes to birth control, for healthy young women without any stroke risk factors, the stroke risk associated with oral contraceptives is very small, experts say. In addition, most oral contraceptives today contain between 20 mg and 30 mg of estrogen, well below the level of estrogen (50 mg and above) known to significantly increase the risk of stroke.

The use of non-estrogen contraception, such as an intrauterine device (IUD), progestin injections, or progestin implant, is recommended for women with multiple risk factors for stroke.

Other unique stroke risk factors for women, in addition to birth control or hormone replacement therapy, include pregnancy, preeclampsia, migraine and heart arrhythmia, according to Brockington.

The signs and symptoms of a stroke are often the same for women and men and include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body; sudden confusion or difficulty speaking and understanding speech; sudden vision loss; sudden loss of balance or dizziness and a sudden, severe headache with no known cause, according to the CDC.

The key to surviving a stroke is to act fast, according to Brockington.

"In acute stroke treatment we say time is brain. The reason why we say that is every moment, every minute that goes by, 1.9 million brain cells die," she said. "You don’t have time … you have to call 911."

Brockington shared an acronym used by stroke awareness advocates to help people remember what to do if stroke symptoms appear.

The acronym, F.A.S.T., advises people to look at the face, arms and speech and then call 911.


F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T—Time: If you see any of these signs, call 9-1-1 right away.

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simon2579/iStockBy SONY SALZMAN, ABC News

(NEW YORK) -- With top White House officials indicating a coronavirus vaccine may be available by January 2021, scientists and vaccine experts outside the Trump administration are cautious but optimistic that a vaccine could be delivered on such an accelerated timeline.

Experts interviewed by ABC warned that developing a vaccine within a 12-month time frame could mean throwing normal scientific standards out the window, but added that a vaccine could be available by the new year if everything goes perfectly.

While President Donald Trump has been bullish in his promise to have a "vaccine by the end of the year," his top advisors have taken a more measured approach, saying a January deadline is a best-case scenario. Last week, Dr. Anthony Fauci, the nation's top infectious disease doctor, said, "we want to go quickly, but we want to make sure it's safe and it's effective."

Since the start of the U.S. epidemic, Fauci has been estimating a vaccine is 12 to 18 months away. But the prior record for vaccine development -- the mumps vaccine -- took four years, meaning Fauci's early estimates drew skepticism among many vaccine experts.

But with the growing sense of urgency as the death toll mounted dramatically in March and April, vaccine developers collapsed the normal development timelines by running concurrent studies that would normally be conducted in a stepwise approach. Meanwhile, drug companies are already scaling up production without even knowing which vaccine is likely to work.

"It is not impossible," said Paul Duprex, PhD, Director of the Center for Vaccine Research and professor of microbiology and molecular genetics at the University of Pittsburgh. "It's of course very aggressive -- but it is possible."

"You'd have to be lucky," said Dr. Paul Offit, co-inventor of the rotavirus vaccine, who sits on the Food and Drug Administration's vaccine advisory committee. "It would be remarkable, but not completely ridiculous."

Dr. Paul Goepfert, professor of medicine at the University of Alabama at Birmingham (UAB) and an expert in vaccine design, said a vaccine by January would only be possible "if everything works out perfectly."

To have a new vaccine by January, experts said a study would need to be conducted in parts of the world where the pandemic is still raging. This would help ensure a big enough group of patients were exposed, and then protected, from the virus.

Then, one of the vaccines currently being developed would have to show positive results, which isn't a guarantee. That vaccine would also have to prove safe, without any dangerous side effects. Finally, vaccine makers would have to be ready with hundreds of millions of doses as soon as data is in hand.

"It is possible but not likely," Goepfert said.

"It's difficult to set exact timelines," said Rinke Bos, principal scientist and immunologist for Johnson and Johnson - one of the companies advancing a COVID-19 vaccine. There are several complicating factors that could easily delay the timeline beyond 18 months, including the fact that the studies will need to be conducted in places where the virus is still circulating.

"Those are quite complicated discussions," she said. "It's very difficult to say something about a timeline."

Right now there are more than 100 vaccines being studied, and at least eight of those have already progressed outside the laboratory and into human studies, according to the World Health Organization. The furthest along include candidates from the University of Oxford, Pfizer, Moderna Therapeutics, Inovio Pharmaceuticals and China's CanSino Biologics.

Many of these vaccines use different technology -- some brand-new to vaccine science -- and experts still don't know which is the most likely to work.

Meanwhile, the White House's Operation Warp Speed has resulted in a handful of vaccine candidates that might work against the novel coronavirus -- although those will also need further study.

Right now, many of the vaccines already tested in people have been accelerated far beyond the normal, methodical timelines. Instead of moving from animal studies in a laboratory to a carefully tiered Phase I, II and III system of in-human study, some of these studies are being conducted simultaneously -- with some even skipping normal animal studies.

Under normal circumstances, it would be too expensive for drug developers and too risky for human volunteers to run these types of studies concurrently. But vaccine developers are deviating from the normal rule book because of the sheer devastation of the global pandemic.

"We as scientists are rather linear individuals," said Duprex. "There are huge financial reasons for that." Now, he said, "there are people taking risks, doing something that might not lead to fruition."

The scientific challenges are unprecedented, considering how little is known about the novel coronavirus that has killed more than 250,000 people across the globe.

For example, said Offit, most vaccines work by triggering an immune response inside the body without making a person sick. But for this novel coronavirus, scientists still haven't had time to adequately study the body's immune response to infection -- meaning we don't know whether an immune system response necessarily protects against a future infection.

And rushing development could mean that important safety issues are missed.

"Most vaccines have been pretty safe, but there have been problems in the past," said Goepfert.

And the downside of immunizing millions of people with a rushed, unsafe vaccine could have long-ranging consequences.

"Vaccines are so, so important for public health," Duprex said. If something goes wrong … the general public will extrapolate that vaccines are unsafe."

"Time is critical, of course, but safety is critical," said Duprex. "In the middle of this fast approach, we absolutely cannot compromise on safety."

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spukkato/iStockBy ANGELINE JANE BERNABE, ABC News

(NEW YORK) -- All her life, 27-year-old Kiah Twisselman believed she just had "bad genetics," which prevented her from losing weight. But two years ago, she proved that theory wrong and went from 285 to 163 pounds by eating healthy and exercising.

"I just started showing up and doing it," Twisselman wrote in an Instagram post. "That's it."

In the new issue of People Magazine out this week, Twisselman's incredible weight loss journey -- along with that of several others -- is highlighted.

The publication's transformation feature spotlights people who drastically changed their lives.

"I lost 100 pounds in less than a year," Twisselman told People. "It’s been so challenging, so rewarding, and I wouldn’t trade this last year for the world."

"She lost 120 pounds by making really small changes to her life that really anybody can imitate," said Charlotte Triggs, the deputy editor of People.

In the beginning of her weight loss journey, Twisselman shared that she wanted to be healthier, so she turned to author and fitness expert, Rachel Hollis, and her five tips to thrive.

On her Instagram page, Twisselman detailed how she adapted Hollis's five daily habits like waking up one hour earlier, writing down 10 things that she's grateful for, giving up food that doesn't "bless her body" and drinking more water.

"Improving your life isn't about making some scary, drastic change overnight," she wrote on Instagram. "It's about meeting yourself where you're at and making small changes over time that you can actually stick with. Start small, stay consistent."

By adapting Hollis's lifestyle changes Twisselman was able to shed the extra weight for good.

"She started working out 30 minutes a day," said Triggs. "She started drinking a lot more liquids which she hadn't been doing before, and keeping a diary so that she could start to feel when she was really hungry."

Now, Twisselman is helping others as a weight loss coach and will soon launch her first ever digital course on her website to teach others how to shed pounds. She also shares motivational videos for her Instagram followers to help inspire them to make small, healthy changes in their lives.

Although quarantine has changed the routines for many, Twisselman says her life hasn't looked too different, and she's still making exercise and hydration her top priorities. She also makes the choice to stick to her lifestyle changes every day to reach her goals.

"If I can do it, you can ABSOLUTELY do it too," Twisselman wrote in an Instagram post. "Stop playing small, dream bigger for yourself and keep showing up."

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Michele HolbrookBy NICOLE PELLETIERE, ABC News

(NEW YORK) -- A mother who lost her only child to an accidental drug overdose is speaking out in hopes of saving lives as overdose deaths raise national concerns during the novel coronavirus pandemic.

Chandler Cook was clean for over a year before his sudden death on April 21. The 28-year-old had grown fond of his job as head barback at a restaurant in Jacksonville, Florida, and was training to become the head bartender.

When he wasn't working, Chandler spent time camping, biking and attending music festivals. He had a great relationship with his mom, Michele Holbrook.

"He was just an amazing young man," Holbrook of Amelia Island, Florida, told ABC News' Good Morning America. "He would give the shirt off his back. In school, if someone was being picked on, he would be on their side. He had a heart of gold."

Holbrook said Chandler emperimented with marijuana and alcohol at the age of 13. At 19, he was prescribed opioid painkillers after a shoulder injury.

"When he couldn't get that any longer, he started using heroin," she explained.

"Where a normal human being could go out and have one glass of wine, with an addict, they cannot do any of that," Holbrook added. "It is overboard and I saw that with him."

Chandler was revived after a heroin overdose in 2017. He then asked to be checked into a drug rehabilitation center.

"He called and said, 'Mom, I need help. I need rehab,'" Holbrook said. "A counselor helped get him into a rehab in Georgia."

"But of course, it's just that vicious cycle," she added. "After that, he came back [and] started using marijuana and other drugs."

Holbrook said Chandler sold to an undercover officer after returning from rehab and served six months in jail. He was placed in another rehab program in Jacksonville.

"As a mother of an addict, you can get angry because you are so frustrated," Holbrook said. "It's a full-circle process."

In a video soon before his death, Chandler is interviewed by his mother, revealing to her his personal struggles with addiction.

"I want to see the stigma of addiction be dropped," Chandler tells Holbrook in the clip. "I want to see this country get better. I had a tough battle with it, and my battle, it's a lifelong thing."

He went on, "Over this past year, I've seen things come back into my life... I have a great relationship with my family again. I have a great job again, I'm healthy, I'm happy."

Once the pandemic hit, Chandler lost his job in food service and began following Florida's stay-at-home orders.

On April 20, Holbrook texted her son, asking how he was holding up.

"I even said, 'I'll be so glad when I can give you a big hug around the neck,'" she recalled telling him.

Chandler never replied to Holbrook's message. The following day, Chandler's friend called Holbrook to tell her he'd be going to Chandler's apartment to check in on him.

When Chandler didn't answer knocks, his friends broke the door down.

"I literally almost passed out," Holbrook said. "What do you do when you think your son's dead or you think something's wrong? I remember walking up to his apartment and Jesus said to me, 'It is OK. It is my turn to look after him.' I think that's what will give me peace, is knowing I will see him again."

Holbrook looked on as police removed Chandler's body from the scene. His death was ruled an accidental opioid overdose.

Holbrook held a social distancing memorial at her family church. Afterward, 250 cars paraded around the building to honor Chandler.

Drug overdose deaths and COVID-19

Chandler is one of many in the nation who have died as a result of a drug overdose over the last few months as the novel coronavirus has killed hundreds of thousands globally.

The COVID-19 pandemic has forced millions of Americans into isolation, as doctors continue to look for a cure.

It's unclear if there's a nationwide trend of drug overdoses happening specifically during the pandemic, though several communities have reported a spike in drug overdose deaths.

In Jacksonville, where Chandler lived, the fire and rescue department reported a 20% increase in overdose emergency calls in March alone. In Columbus, Ohio, the county coroner's office saw a surge in overdose deaths, including 12 in a 24-hour period the first week of April.

And at least four New York State counties have acknowledged an increase in reported overdoses, including Erie County, where officials saw at least 110 drug overdoses, including 36 deaths, reported since the beginning of March.

Aliese Alter is the senior program manager for the Overdose Detection Mapping Application Program (ODMAP) Program Office based out of Baltimore, Maryland.

ODMAP is free of charge to first responders and government agencies, and is funded through Washington/Baltimore High Intensity Drug Trafficking Area by the Office of National Drug Control Policy.

ODMAP is a mobile friendly interface which can be accessed by phone, tablet and computer, and which helps those on the front lines of the overdose epidemic track both known and suspected fatal and non-fatal overdose incidents.

Agencies and states are not mandated to use ODMAP, though participation is wide with over 3,300 participating agencies across 49 states, Puerto Rico and D.C. There's been over 265,000 suspected overdoses submitted.  

Since March 24, as stay-at-home orders continue to be enforced, ODMAP has been releasing weekly reports analyzing the possible implications of COVID-19 on the overdose epidemic.

"Although several U.S. communities have reported a spike in overdose deaths, it's still unclear what nationwide trends are, due to several evolving variables," Alter explained.

To understand the full reach of the overdose epidemic, Alter said there's much to consider including seasonality, unemployment rates, the current state of the economy and how it will affect people who use drugs.

Recently, ODMAP released an analysis evaluating the possible consequences of COVID-19 on the overdose epidemic (meaning all drugs, including opioids and stimulants).

What it found was that historic data modeling would not have predicted the increase in overdose activity present in the ODMAP submissions since the onset of COVID-19.

Suspected overdose submissions to ODMAP have risen 16.56% based on a 30-day average comparison from 2019 to 2020. A comparison of raw numbers yields an increase of 11.39% for fatal overdoses, and an increase of 18.64% for non-fatal overdoses during that same time period.

May 2020 is showing a continuation of this trend, with an increase of 8% in overdoses in the first six days of the month, when compared to 2019.

As ODMAP notes in its May 13 report regarding overdose data, ODMAP submissions and COVID-19 cases, "correlation does not imply causation."

Though, experts are growing concerned about the effects the pandemic may have on people like Chandler, who Holbrook believes wouldn't have relapsed if it weren't for the current state of the world.

"Once our city and nation and government shut down, he had no where to go," Holbrook said. "Now you're looking at no job, and structure is gone. There's no income and stress. There's isolation and no one to hang out with because we have to follow strict guidelines."

"They lose everything that was helping them stay clean and sober," she added.

In a statement to ABC News in April, regarding increased reports of overdose deaths, U.S. Attorney for the Western District of New York James Kennedy Jr. said, "I think we need to consider the role that social isolation coupled with nonstop reporting on the pandemic may have on the feelings of desperation and hopelessness among those struggling with substance abuse."

"Amidst the current crisis, we need to remember that substance abuse existed long before COVID-19, and it will likely remain long after we have wiped out the virus," Kennedy added.

Recovering from addiction during the COVID-19 pandemic

Dr. Janet Taylor is a psychiatrist at Centerstone of Florida and treats people with addiction.

Taylor said isolation can be more challenging to recovering addicts as they may rely on routine and positive distractions to maintain sobriety.

And with more than 38 million Americans left jobless, daily routines have arguably been compromised.

"Employment is important for positive mental health and self esteem." Taylor told GMA. "A lot of my clients are really frustrated and feel like they're going stir crazy. Historically, they would turn to using and some have. Many are trying not to, but those cravings and desires, especially to control moods, people struggling with addiction have to deal with it every single day."

Additionally, those in recovery have been stripped from normal resources due to social distancing guidelines.

Taylor admitted help may be harder to find, but it's crucial to get creative in order to stay clean and sober.

Below, Taylor offers advice for people struggling with addiction during the pandemic and their loved ones:

1. Reach out to your sponsor.

2. Keep in touch with friends and family.

"If lonely, find a healthy connection," Taylor said.

3. Keep active, whether it be mental or physical.

"It's a time to self-reflect and think about your sense of purpose," Taylor said. "Think about small goals, like the fact that you didn't use in a day. Work on GED, a resume. Do positive activities to help you so when restrictions are lifted, you're ready."

4. Alcoholics Anonymous and Narcotics Anonymous offering virtual meeting options using a computer or phone.

5. Telehealth services uses Zoom, video tech or phone to conduct exams.

6. Call 911's non-emergency line and its dispatchers can direct you to appropriate resources.

"Treatment is there 24/7. It may be harder to access, but be resourceful," Taylor said. "Now is not the time to stop what you're doing."

7. For family and friends of people in recovery, it's important to check in.

"Some burn bridges, and you'll have firm boundaries," Taylor said.

 Holbrook agreed, even offering her own telephone number to those who come across Chandler's story. "If your family member is struggling, Zoom them, FaceTime them," she said.

"Get in their face," she added. "Don't let it be too late."

Holbrook, who does advocacy work for the Children's Tumor Foundation, now hopes to start a non-profit educating kids in Chandler's memory.

If you're struggling with addiction, the Substance Abuse and Mental Health Services Administration can help you locate a treatment facility. Their helpline is free, confidential and open 24 hours a day: 1-800-662-HELP (4357).

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Courtesy Melissa AlcantaraBy HALEY YAMADA, ABC News

(NEW YORK) -- SKIMS aren’t the only thing Kim Kardashian West relies on to look fantastic in every outfit. She also puts in work with celebrity trainer Melissa Alcantara.

Alcantara just published her first book, Fit Gurl: The Total-Body Turnaround and shared five moves with ABC News' Good Morning America to start shaping up for the summer.

Just get a resistance band and be ready to feel the burn.

1. Kneeling banded hip thrusts

This exercise focuses on the glutes.

First, put the band around your hips. Then, while kneeling and with your back toward something sturdy and secure such as a bench or heavy table, wrap the band around that heavy object.

Next, after leaning back into almost a sitting position, thrust your hips forward while keeping your chest engaged and your shoulders away from your ears. Do four sets of 30 reps on each leg.

Tip: Your knees should be spread wide and your feet should touch behind you, and your upper body should be locked. When thrusting, think of shooting your body upwards versus forward so that your hips and glutes do all the work.

2. Standing banded hip abduction

This one’s for the glutes and hips.

First, stand tall and step into the band with the first leg that you’re working. Then, take a few steps away from the band to create tension.

Now, stand firmly on the planted foot and lift your working leg up to the side of you. Lift each leg 15 times in four sets.

Tip:
Hold onto a sturdy platform to help drive the leg upward, and really put the focus on using the hip and glute and not the foot.

3. Standing banded kickbacks


This exercise focuses on glutes.

First, stand tall and slip the band under your heel on your working leg. Place the band around a sturdy surface and take a few steps away from the platform to create tension in the band.

Then, while facing the sturdy platform, slightly bend your opposite, non-working, knee and sit your hips back in a lunge-like position. Hold onto the table or bench that your band is strapped to with both hands, and push your working foot up and back behind you in a straight line, really squeezing your glute at the top. Work each leg 20 times in four sets.

Tip: Make sure you give the band enough tension that when you bring the working knee back to the starting position that the band does not loosen and fall from your foot.

4. Banded pull-throughs

This move works the glutes and hamstrings.

Secure the band to a sturdy surface, and face away from the surface while grabbing the band with both hands between your legs. Take a few steps away from the table or bench to create tension in the band.

Then, while standing tall with both knees slightly bent, shoulders away from your ears and your chin tucked, push your hips back and then power your hips forward. Really squeeze your glutes when driving your hips forward. Perform 30 reps in four sets.

Tip: Both hands should be wrapped around the band and resting against your thighs. You don't want to use your hands or upper body to pull. This ensures it’s all hip movement.

5. Lying banded hamstring curls


This exercise will hit the glutes, hamstrings and calves.

First, lie on the ground face down, place the band around a sturdy surface and then place it around your feet.

Step away slightly from the sturdy platform to create tension and hold the band in place around your feet. Then, pull your heels up and as close to your glutes as possible. Curl your hamstrings for 100 continuous reps.

Tip: Keep your chest and head up as you press your hips against the floor. Your hips will want to rise, but make sure you push down firmly as you raise your legs.

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ABC News(WASHINGTON) -- BY: BENJAMIN BELL and FERGAL GALLAGHER

The crippling spread of COVID-19 across the globe has progressed in parallel with a flood of information online relating to the pandemic. The World Health Organization branded that spread as an "infodemic" earlier this year.

The "infodemic" has highlighted the importance of readers identifying false information about the coronavirus and those who might be spreading it.

Here's a look at potential sources of false information and a few quick embedded tips to deal with it.

If you have to remember one thing, always consider the source of the information. Ask yourself: Is the information from a trusted and authoritative entity? If not, then you should proceed with caution.

ABC News took a look at the different types of people spreading false coronavirus information and their motivations for doing so.

Conspiracy theorists

Conspiracy theories are not new but social media has allowed people the world over to convene and build fantastical theories. Some of the efforts to spread this misinformation are very well coordinated and cause real world damage, like the "pizzagate" conspiracy that resulted in a shooting in Washington, D.C.

There is no shortage of conspiracy theories circulating online relating to COVID-19. Earlier this month, a slickly produced conspiracy film focused on the novel coronavirus was viewed millions of times, according to The Verge, as platforms tried to remove it from their sites. Many of the shocking conspiracy theories put forth about COVID-19 are specifically meant to manipulate the consumers' emotions, experts say.

Before believing or sharing the content out of fear or anger, "take a breath" as First Draft's Claire Wardle told ABC News earlier this year. A simple check of the source or a quick search can help vet something that may seem suspicious, according to experts.

"If it seems like a really detailed and hard-to-follow network of information related to the interests of different parties in spreading COVID-19, you are probably looking at a conspiracy theory," Joan Donovan, an expert who studies disinformation campaigns at Harvard University's Shorenstein Center on Media, Politics and Public Policy, told ABC News. In March, multiple tech giants issued a joint statement saying they planned to work together to fight misinformation and elevate authoritative content.

"We're helping millions of people stay connected while also jointly combating fraud and misinformation about the virus, elevating authoritative content on our platforms, and sharing critical updates in coordination with government healthcare agencies around the world," the statement read in part.

Scammers

Donovan's advice to avoid scams is pretty straightforward: You should avoid buying things -- insurance among them -- from vendors you are not familiar with.

"Right now, you should only do businesses with those you've done business with in the past," Donovan said. "There is little chance of an 'amazing deal' on life insurance, masks, hand sanitizer and other items. Be very cautious of putting your credit card number into new websites and never click a link that comes to you via ... unsolicited text message."

Similarly, while not necessarily being an intended scam, false or misleading marketing of products related to COVID-19 is something to be on the lookout for as well, experts warn.

Politicians and foreign powers

President Donald Trump, who has a history of making false statements, is not the only politician who has made unproven claims. But he presents a unique problem when it comes to the spread of inaccurate information. As leader of the world's most powerful democracy, the president possesses an extremely powerful platform and the ability to reach billions of people instantly. Trump has a history of saying things that are untrue or misleading.

The president has made unproven, misleading and confusing statements since COVID-19 hit the United States. For example, he initially downplayed the outbreak and said it was under control, and recently suggested that a disinfectant may be able to be injected as a treatment against it.

Trump has defended his administration’s response by, among other ways, saying he blocked travel from China, where the virus is believed to have originated. He also said he was being “sarcastic” about the disinfectant remark.

Still, it is important for news outlets to fact check and add context to the president's assertions, experts advise.

"Sharing misinformation only makes things worse, whether it's from a politician or anyone else," Donovan said.

Foreign nations have also been accused of spreading false information. The State Department said it has identified campaigns by Russia, Iran and China to spread disinformation about the pandemic.

Earlier this year, with no evidence, China's Foreign Ministry spokesperson promoted the theory that the United States was responsible for the outbreak, saying the American military brought the coronavirus to China in October.

Members of the White House, including Trump and Secretary of State Mike Pompeo, have also speculated, without evidence, that the coronavirus may have been released from a lab in Wuhan, China, a claim China denies.

Political operatives

The second category of political operatives includes groups of people pushing a specific agenda who are not officially linked to the state or a specific political party, such as anti-vaccine protesters. "The biggest players are those who are pushing health misinformation based on conspiracies about the deep state, and who reject science and evidence that COVID-19 is a devastating illness," Donovan said.

Family, friends and celebrities

Yes, it is a risk -- especially during a health crisis -- to assume that the information offered by your friends and family is always accurate. Again, it is important to always try to ascertain the source. Also, it's OK to "compassionately engage" your friends and family members who you know are sharing false information, Donovan said.

In terms of celebrities, just because they are famous does not mean they are putting out accurate information. Be wary. Be skeptical. Your favorite actor or sports star is not the place you should be getting the latest updates on the pandemic.

"We saw how impactful celebrities were in the past when they spread health misinformation that vaccines cause autism. Celebrities, because they are newsworthy and have fans, become the perfect amplifier for misinformation," Donovan said.

Conversely, celebrities can use their social media reach to spread accurate information, as exemplified recently when certain celebrities, including Julia Roberts and Millie Bobby Brown, handed their accounts over to coronavirus experts such as Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases.

Satire

This category is pretty easy. Certain sites or accounts intentionally produce information intended to entertain, not inform. For example, The Onion famously produces satirical "news pieces."

Always knowing the source of your information is key here -- as it is generally.

For those users interested in a deeper dive, ABC News has previously published a guide to spotting disinformation and First Draft has collated helpful resources related to online verification and the coronavirus.

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Paul Archuleta/Getty ImagesBy MEGAN STONE, ABC News

(NEW YORK) -- Sailor Brinkley-Cook, who recently competed in last season's Dancing with the Stars, opened up about her relationship with her body image in an Instagram post.

The 21-year-old, who is the daughter of model Christie Brinkley, revealed that she suffers from body dysmorphia.

Along with a series of photos on Sunday, Brinkley-Cook wrote the post which included lyrics from Kendrick Lamar's "Humble" before revealing "I've been so down on myself recently."

The young model wrote that she had been "Crying about my cellulite, letting the fat on my body ruin my day, getting mad that i'm not as skinny as i once was."

"The body dysmorphia and left over eating disorder tendencies have been coming in strong," Brinkley-Cook wrote. "As i come into myself as a young woman my body shifts and changes by the month, the "control" i felt i once had over it has been completely stripped away from me."

While scrutinizing her imperfections, the DWTS alum revealed what caused her to start spiraling. "I go on instagram and scroll through photos of girls that look "perfect".. shiny skin with not a bump to be seen, tiny little waist and thighs that look like chopsticks. And i compare myself," she admitted.

However, the 21-year-old added that she's taking steps to break from that mindset by reminding herself that she is healthy. She also wrote that she hoped her emotionally vulnerable post inspires other young women to break from the negative spiral while learning to love and be proud of their body.

"If you're out there hating on yourself, stop!! Appreciate yourself. You're body is so magical," she encouraged, later affirming that she is learning to embrace her own imperfections.

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Bill Oxford/iStockBy ERIN SCHUMAKER, ABC News

(NEW YORK) -- If you've been reading coronavirus news coverage, you've likely stumbled across a reference to a term called "R0." It's been on the tips of world leaders' tongues in recent months, including German Chancellor Angela Merkel's, whose R0 explanation garnered nine million views on Twitter in April.

Pronounced "R-naught," the reproductive number is an indicator of how contagious a disease is, or how easily it spreads from person to person in a community. The number is important because government leaders are using R0 as a proxy for determining whether their respective COVID-19 outbreaks are growing, shrinking and or holding steady.

Crucially, R0 is not a fixed number. It's a jumping off point that's influenced by many factors, including human behavior.

What is R0?


The reproductive number of a virus, or R0, is the number of people, on average, that one infected person will subsequently infect. The naught in R0 refers to the zeroth generation of a disease, as in "patient zero." A higher R0 means more people will be infected over the course of the outbreak. A lower number means fewer people will be infected over time. That replication will continue if there are no vaccinations against the illness or immunity in the population.

Because that number is imprecise and variable, it's often expressed as a range.

Here are a few examples:

If R0 is 1, each infected person infects just one other person, on average. Over time, the number of infected people will remain the same.

If R0 is less than 1, each sick person is infecting fewer than one person, on average, so the number of infected individuals will shrink over time. In case case of COVID-19, and R0 of less than 1 means lockdown measures could be eased.

If R0 is greater than 1, each sick person is infecting more than one person, on average, so the outbreak will grow. So, lockdown measures may need to remain in place.

And while R0 = 1 and R0 = 2 might seem close, "the difference between a reproductive number of 1 and a reproductive number of 2 is huge, in terms of the number of people who will ultimately be infected," Emily Gurley, an associate scientist at Johns Hopkins Bloomberg School of Public Health, explained during an online course she teaches about contact tracing.

"Everything we can do to help us get the reproductive number closer to 1 will help us control the spread of a disease," Gurley added.

Measles, which is one of the most infectious diseases that scientists know of, has an R0 of about 15. (While there's some dispute about this number, measles is frequently cited as having an R0 between 12 and 18 in scientific literature.)

With an R0 of 15, every person infected with measles will go on to sicken 15 additional people.

On the other end of the spectrum, MERS, or Middle East Respiratory Syndrome, another type of coronavirus, has an R0 lower than 1, meaning on average, each infected person infects less than one other person. Because of that low reproductive number, MERS does not usually result in large disease outbreaks.

For now, scientists have calculated the R0 of the novel coronavirus to be between 2 and 3, meaning each infected individual will infect to two to three additional people, on average.

As a historical comparison, the R0 of the 1918 Spanish flu pandemic is estimated to have been between 1.4 and 2.8, according to an article published in BMC Medicine.

What are the limitations of R0?

They're numerous.

Some government leaders have framed their discussion of R0 as a race to get below 1, but like many scientific concepts, R0 is more complicated than a one-time race to success.

R0, which involves modeling, can change from place to place and is impacted by human behavior. It involves imperfect and different estimates based on assumptions and educated guesswork by scientists. As researchers aptly noted in a paper published in the journal Emerging Infectious Diseases last year, R0 is "easily misrepresented, misinterpreted, and misapplied."

As in the case of measles, scientists continue to disagree on the R0 of even diseases they've been studying for decades.

In the United States, the COVID-19 outbreak has not been uniform. Different regions, states and cities have had their own micro-outbreaks, which are on different timelines, making it hard to assign one R0 to the entire country. New York City, Seattle and Chicago may have very different R0 numbers than one another.

That's not to say governments shouldn't try to lower their R0 numbers. Though imperfect, it's a useful proxy for estimating how the lockdown and reopening policies of states and cities are working -- or not.

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'Hug Time' inventor, Carly Marinaro, pictured in front of her plastic hug shield she made from PVC pipe, a window insulator kit, and industrial gloves in Rockford, Illinois. - (Courtesy Carly Marinaro) By HALEY YAMADA, ABC News

(ROCKFORD, Ill.) -- While hugging has proven difficult amid social distancing guidelines from the coronavirus pandemic, that didn't stop Carly Marinaro, who created the "Hug Time'' plastic shield, from surprising her 85-year-old grandmother with safe hugs from her and her grandchildren.

Marinaro, from Rockford, Illinois, said it was Mother's Day that motivated her to put together the plastic device as a surprise for her grandmother, Rose Gagnon.

"I am really close with my grandmother and my kids are as well," said Marinaro, who added that she used to see Gagnon close to every day for morning coffee. "When Mother's Day rolled around and she wasn't able to physically be with any of her children, grandchildren or great-grandchildren, she was pretty sad."

"We are a family of huggers," said Gagnon. "That's how our family shows love."

Marinaro said she got to googling and searched for long plastic gloves, PVC pipe and a window insulation kit. She spent less than $50 on materials and, with a little help from a local hardware store, assembled the 'Hug Time' in about an hour.

"It was fairly simple and quick," said Marinaro. "I am an artistic person and a very visual person ... I've been making things for years."

Gagnon said she got a call and specific directions from her great-grandchildren to come over for the surprise.

"[They] said, 'Nana, you have to comb your hair and put lipstick on ... we're going to have a video," said Gagnon with a laugh. "When I got there, I was totally shocked. I could not believe what [Marinaro] had done. She knew that I was missing my grandchildren ... I just missed my hugs."

"I knew this was for her, that's why we did it, but I didn't realize it was just as much for the kids and for me," said Marinaro. "We were thinking she needed this, but [we] all needed it."

Neither Marinaro nor Gagnon expected so much local attention from the moment, but felt happy to spread joy during this time.

"It just blows my mind the response that it's gotten and it's done out of love, not anything else," said Gagnon, who is looking forward to a real hug sometime soon. "It's been hard to stay away from my family ... that warm fuzziness in their hearts ... that's what we're after."

Copyright © 2020, ABC Audio. All rights reserved.

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HRAUN/iStockBy DR. JAY BHATT and OLIVIA RUBIN, ABC News

(NEW YORK) -- As the nation moves towards recovery and reopening, one emerging reality in the aftermath of the coronavirus outbreak is that the American health care system will see its own new normal in the coming weeks and months, according to experts and doctors.

Strapped for cash and some protective equipment, and forced to re-write protocols to better fortify against the contagious spread of COVID-19, doctors’ offices and hospitals across the country are beginning to rethink their approach to personal care -- from an increase in telemedicine and widespread coronavirus testing for patients, to the complex math about which procedures should go ahead and how.

“This is an opportunity to ask, what do we really need to do and what do we need to not do,” Robert MacLean, former president of the American College of Physicians, told ABC News. The pandemic “has gotten us back to doctoring. We need to take advantage of that and critically look at the utilization of lot of things we have done.”

While virus patients flooded into some hospitals, elective and other non-emergency surgeries came grinding to a halt, causing drastic financial strain on facilities big and small. Now, as with the rest of the country, doctors have cautiously started to resume those procedures.

As of this report, at least 30 states have reportedly relaxed mitigation strategies related to surgery, and it appears more are on their way.

University of Michigan Health System has reopened its elective surgeries, but officials there said they are unsure how long it will take for the hospital to be ready for the old pace of activity.

Dr. Andrew Ibrahim, a general surgeon at University of Michigan, said physicians there are weighing the benefits of each surgical procedure against the risk of COVID-19 and the resources available. The resumption of procedures so far has been gradual.

“We've brought back surgery slowly based on their time-sensitivity in line with [Michigan] Gov. [Gretchen] Whitmer's orders,” he said.

Ibrahim said the hospital created a central committee to prioritize which cases need more urgent attention, relying on specialists to help triage the cases.

In Nebraska and Kentucky, hospital administrators and physicians like Dr. Prakash Pandalai, a surgeon at University of Kentucky, said they started by prioritizing cancer operations, surgeries needed to prevent loss of a limb, and procedures needed to prevent further acceleration of disease.

"But we need to be careful about ensuring that there is enough protective equipment for providers and patients as we come back online," Pandalai said.

'Watching PPE supplies and flow very carefully'

As Pandalai indicated, beyond the urgency of the procedures for patients, one limiting factor is the supply of personal protective equipment, better known as PPE, that became such a focal point as the coronavirus spread.

PPE is not necessarily the same for various surgeries as it would be to treat COVID-19 patients, but there is enough of an overlap in basic protective equipment that health care officials told ABC News they're taking careful note when considering the amount of PPE that would be expended for a particular operation and how much PPE they might need if a resurgence of COVID-19 strikes.

Jeffrey Tieman, president and chief executive officer at the Vermont Association of Hospitals and Health Systems, said that if hospitals "don't feel confidant in PPE supply, you need to think about whether you can continue to offer those elective procedures."

Dr. Kat McGraw, physician and chief medical officer at Brattleboro Memorial Hospital in Vermont, said that since the state has allowed outpatient surgeries to resume, the hospital has been "tasked with that responsibility of being able to self supply surge PPE if we want to be able to go forward with elective procedures."

McGraw said the hospital has developed its own stockpile of PPE for an emergency, which she compared to a blood bank.

"We have been purchasing not through our usual streams, but trying to find creative ways to get augmented amount of PPE, but thats not necessarily sustainable," she said. "The trick to moving forward with surgery is making sure it doesn't impeded with our ability to have everything in place for our ability to manage a surge for COVID-19."

Dr. Brandon Mauldin, the chief medical officer of the Tulane Health System in Louisiana, referred to this dilemma as a "balancing act."

"Because we have initiated and started back on elective surgeries as [COVID-19] patients have declined, the balancing of it is a lot easier to do," Mauldin told ABC News. "So we feel more comfortable that we have sufficient PPE."

Others are not as confident. Dr. Sharmila Makhija, chair of OBYGN at Montefiore Medical Center in the Bronx, said she and other colleagues "across the country" are "worried about whether we have enough personal protective equipment to do elective surgeries."

Somewhere in the middle is Providence Health, which serves urban and rural communities from Alaska to Southern California. The chief value officer there, Dr. Joanne Roberts, told ABC News they are "watching PPE supplies and flow very carefully as we resume non-emergent procedures."

Remote screenings and coronavirus tests as pre-op

One strategy to save on PPE, as well as improve general safety amid the coronavirus spread, is the increasing use of telemedicine -- what one doctor said may become a pre-operation "new normal."

Dr. Aleaf Worku, at CareMore Health, said it will be more likely that patient assessment -- the initial practice of seeing what kind of care a patient needs -- could be done remotely, sparing the patient a visit to the hospital and sparing medical professionals from coming in physical contact with the patient.

“This is why telemedicine may be the way we do pre-op screening in the new normal,” Aleaf said.

Another potential new normal for pre-op? COVID-19 testing.

That's the strategy McGraw said her Virginia hospital has adopted. Patients coming in for surgery are tested 72 to 96 hours in advance of the procedure and are required to self-isolate during that time.

She said patients should think of this as part of the new standard "pre-op" steps that so many have come to know before going in for any sort of procedure, which often include precautions such as refraining from eating or drinking for 12 hours.

"Now, everybody needs their [coronavirus] test," McGraw said.

Doctors at hospitals in California, Texas, and Louisiana said they are doing universal testing for patients scheduled for surgeries.

The testing "gives reassurance to both patients and providers, even beyond just doctors nurses, that we are doing all we can to create a COVID-safe environment," said Dr. Loren Robinson, who practices at Christus Health in Texas.

But protocols are not the same, even within the states. Dr. Quyen Chu at Oschner LSU Health in Shreveport, Louisiana, said the hospital is doing universal testing for patients undergoing elective procedures, but Mauldin at Tulane said his hospital system in Louisiana hasn't quite gone that far.

Patients and doctors there are working together to determine if testing is necessary on a case by case basis, Mauldin said. The hospital has taken other precautions, including universal masking and staggered patient appointments.

As hospitals feel financial pinch, COVID-19 sparks larger questions

Beyond the staggering human suffering, another casualty of the coronavirus' spread is the financial stability of hospitals and other health care facilities at a time when many are needed most.

Some hospitals are in dire trouble, despite billions of financial support to the industry from the federal government.

“One sad reality is that smaller or stand-alone hospitals may have lost too much revenue the last two months to remain viable,” said Ibrahim.

Physicians interviewed by ABC News predicted a wave of hospital closures could strike this summer.

"How is it possible for hospitals to be so vital at the same time they're so vulnerable and what is the solution in the new normal?" asked Deb Gordon, a consumer health advocate.

For those that survive, like many belonging to larger systems that have multiple hospital locations, health care officials said COVID-19 may be the catalyst for asking and answering bigger, long-term questions related to what's called value-based care, a philosophy that seeks to change how much is spent on health care as a nation and improve outcomes. The approach prioritizes keeping people healthy rather than having to deliver and pay for avoidable and unnecessary care that is inefficient and may not improve health.

For example, in the aftermath of the coronavirus, health systems may be more willing to reorganize care so it meets patients where they are at in their health journey and keep them safer, such as ambulatory surgery centers and improved care at home.

While the moves can also make sense from a financial perspective, experts warned they will need to be balanced against potential safety concerns.

Value-based care also prioritizes chronic disease management, a significant issue that has been exposed during the pandemic. Those with chronic diseases are more likely to have worse outcomes if they contract the coronavirus.

Telemedicine and remote patient monitoring could allow for better management of chronic diseases earlier and prevent patients from showing up in a healthcare setting that can potentially expose them to the virus.

"It is a fascinating time. The opportunities are huge," Providence Health's Roberts said.

But for all the changes hospitals could make, much is going to depend on whether patients feel comfortable enough to come in at all. ABC News has reported that people are foregoing in-person consultations of even potentially serious conditions for fear of COVID-19.

"We did just complete a patient sample survey of 12,000 volunteers, and the biggest barrier does seem to be their fear of getting COVID in our facilities. Only 18% say they feel safe going back to clinics, [emergency rooms], or hospitals," Roberts told ABC News.

With the new safety measures, hospitals and doctors across the country hope to change that.

Copyright © 2020, ABC Audio. All rights reserved.

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