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Major recall on ready-to-eat sandwiches, salads, snacks and more due to listeria concerns

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(NEW YORK) -- More than 400 types of ready-to-eat food products sold under multiple brand labels have been recalled over possible listeria contamination.

Fresh Ideation Food Group LLC announced the recall in a press release posted on the U.S. Food and Drug Administration website Friday. The impacted products include ready-to-eat sandwiches, salads, yogurts, wraps and other items sold in nine states and the District of Columbia from Jan. 24 through 30 "in retail locations, vending machines, and during travel with transportation providers," according to the company.

The Baltimore-based food manufacturer said that no illnesses have been reported, as of time of publication.

Fresh Ideation Food Group initiated the recall after "environmental samples tested positive for Listeria monocytogenes," the company said in its recall announcement.

The affected products were sold under 13 different brand labels.

Click here for the full listing and product information from the FDA.

"All recalled products have a Fresh Creative Cuisine label and/or identifier on the bottom of the label with the Fresh Creative Cuisine name and a fresh through or sell through date ranging from January 31, 2023 through February 6, 2023," the company stated in Friday's announcement.

The company has urged consumers who purchased the products to contact Fresh Ideation Food Group LLC by phone at (855) 969-3338.

According to the Centers for Disease Control and Prevention, listeria can cause severe illness "when the bacteria spread beyond the gut to other parts of the body" after a person consumes contaminated food. Those at higher risk include pregnant people, those aged 65 or older, or anyone who has a weakened immune system, the CDC says.

"If you are pregnant, it can cause pregnancy loss, premature birth, or a life-threatening infection in your newborn," the CDC states on its website. "Other people can be infected with Listeria, but they rarely become seriously ill."

According to the CDC, anyone infected with listeria may experience "mild food poisoning symptoms" such as diarrhea or fever, and many recover without antibiotic treatment.

Copyright © 2023, ABC Audio. All rights reserved.

New York City to end COVID vaccine mandate for city workers

Michael Nagle/Bloomberg via Getty Images

(NEW YORK) -- New York City workers will no longer need to be fully vaccinated against COVID-19 to be employed by the city, Mayor Eric Adams announced Monday.

The mayor said the vaccine mandate for city employees will end Friday, nearly 15 months after his predecessor, Bill de Blasio, implemented the policy, during a vote by the city's Department of Health. Adams said 96% of the city workforce has received both shots so the mandate for current and prospective employees served its purpose.

"This is the right moment for this decision," Adams said in a statement.

By comparison, 90% of New York City residents over 18 have completed their COVID-19 vaccine series as of Monday, according to data from the city's Health Department.

De Blasio issued the mandate on Oct. 29, 2021, and was met with protests and criticism from some employees from various city agencies, including the fire department, police department and department of education.

Roughly 84% of the city's roughly 331,000 workforce was fully vaccinated when the mayor announced the mandate, according to city data.

Despite those protests, the number of vaccinated city employees rose between de Blasio's announcement earlier in October and the deadline, with 83% of all city employees reporting they were fully vaccinated before the deadline, city data showed. By Nov. 1, the first full weekday after the mandate went into effect, 90% of the city's workforce was fully vaccinated, the data showed.

Those who weren't granted a religious or medical exemption were placed on unpaid leave and some later were terminated.

The Health Department said 1,780 city employees were fired for not complying with the mandate. The agency said those former employees won't automatically return to their previous positions but "will be able to apply for positions with their former agencies through existing city rules and regulations and hiring processes."

Adams urged residents to get their vaccine shots and boosters if they haven't done so.

Since the vaccines were made available to the public two years ago, the weekly hospitalization rate of COVID-19 cases among 100,000 unvaccinated New Yorkers was 36.84 compared to 6.82 among 100,000 boosted New Yorkers, Health Department data showed.

Copyright © 2023, ABC Audio. All rights reserved.

'I felt powerless': Black Americans suffering from long COVID say they have trouble accessing care

Chimére Smith, 40, from Baltimore, Maryland, during a function at the school where she was a teacher in Feb. 2020, before she contracted COVID-19. - Courtesy of Chimére Smith

(NEW YORK) -- Throughout the pandemic, Black Americans have made up a disproportionate share of cases, hospitalizations and deaths compared to any other racial or ethnic group.

Now, doctors and advocates are warning the Black community is facing another barrier: access to long COVID care.

Long COVID occurs when patients who were infected with the COVID-19 virus have lingering symptoms for more than four weeks after recovering. In some cases, these symptoms can persist for months or even years.

It's unclear what causes people to develop the condition, but research is ongoing.

According to data from the U.S. Census Bureau Household Pulse Survey, with the latest update conducted between Jan. 4 and Jan. 16, 28.7% of Black respondents said they currently have or have had long COVID.

By comparison, 27.6% of white adults reporting having or having had long COVID. Hispanic adults were the only racial/ethnic group with a higher percentage reporting long COVID at 31.7%.

However, when it came to adults currently with long COVID who are suffering from significant limitations, Black patients had the highest share of people reporting, the survey shows.

Data shows 34.6% of Black Americans with long COVID report severe limitations on their ability to perform day-to-day activities. Hispanics had the second highest rates of severe physical limitations at 32% and those who reported being multiple races or another race were 30.5%.

'Nobody wanted to listen to me'

One of those people is Chimére Smith, a 40-year-old former middle school English teacher from Baltimore, Maryland.

Smith said she contracted COVID in late March 2020. Her symptoms started off with a scratchy throat and soon progressed to a myriad of symptoms including extreme fatigue, a persistent cough, fogginess, headaches, nausea, diarrhea and spinal pain.

"I remember trying to do some type of social media dance with my partner and after like two minutes, I had to sit down because the world was spinning," she told ABC News. "And so, within those first few days, as I said to my partner, 'I think I have COVID.'"

Smith said she went to two hospitals in the Baltimore area, both of which were familiar with her medical history, but doctors refused to test her for COVID-19.

"They told me that my symptoms were not profound enough to test," she said. "They told me that they didn't have enough tests. They told me that I was fine and that I was just being anxious because we were out of school for the unforeseeable future. I got a lot of doctors telling me I was anxious, and that I was okay."

However, Smith's symptoms continued for several weeks and even months, to the point where she lost vision in her left eye and was left unable to work or drive.

Smith said she paid more than a dozen visits to doctors and hospitals asking for help, but she said she was discharged after every visit with no treatment plan in place.

Smith said she had never been dismissed by a doctor before and felt discouraged.

"I felt extremely frustrated," she said. "I was incredibly sad and depressed about that. I felt very despondent. I had several white male doctors sit at my bedside and ask me, 'Are you sure there's nothing personal going on in your life? Are you sure? Is it a relationship issue? Was it a job issue?'"

She continued, "But nobody wanted to listen to me. And so, it was infuriating. I felt powerless. The way that some of those doctors talk to me, I can tell they were talking to me that way because I was a Black female patient, who they assumed did not know anything about what was happening to her body."

In April 2021, Smith testified before the U.S. House Energy and Commerce Subcommittee on Health on the lingering effects of COVID-19.

Implicit bias in the medical field

There is a history of distrust when it comes to the Black community and the health care system due to beliefs among patients that doctors won't treat them as well as their white counterparts. A 2012 meta-analysis found Black patients were 22% less likely than white patients to receive any pain medication.

There is also a fear of being used as guinea pigs in clinical research or other studies as what occurred during the Tuskegee experiments from 1932 to 1971.

Black men were injected with syphilis to track progression of the sexually transmitted in infection, but the study was conducted without informed consent and patients never received treatment for the disease.

What's more, eugenics movements in the 20th century saw many women across communities or of color forcibly sterilized.

Dr. Panagis Galiatsatos, an assistant professor and physician in pulmonary and critical care medicine at the Johns Hopkins University School of Medicine, told ABC News there is unconscious and implicit bias in the medical field that may lead to doctors dismissing Black patients compared to white patients.

"I can tell you, for a lot of affluent patients coming to our clinic or white patients, what got them to this clinic is that their doctor took their symptoms seriously and got him to our clinic," Galiatsatos, a member of the Johns Hopkins Post-Acute COVID-19 Team, said. "Counter that with disadvantaged patients from a socioeconomic standpoint or Black/African-American patients, it took them several doctors to listen to what they're experiencing before someone took them seriously."

During the period when she thought no one was listening to her, Smith said she felt like she was going to die before anyone figured out what was wrong.

It wasn't until a year and two months after Smith's symptoms first began that she visited a doctor who told her she believed that Smith was suffering from long COVID.

"I had a doctor's appointment on May 20, which was my 39th birthday, and on that day was when a physician, a Black woman said to me, for the very first time, 'I believe you,'" she said. "And when she said that I cried like a baby. Because I could not believe somebody was actually telling me, 'I believe you. Everything that you're saying to me, convinces me that you had COVID.'"

Trouble accessing care

It's not just a matter of getting doctors to believe Black patients. There's also trouble accessing care among the Black community.

"So, with my own eyes, my colleagues and I have seen it in our own clinic, where those that are so economically disadvantaged, those of minority race, their persistence of symptoms by the time they get to our clinic have been going on for a little over a year," Galiatsatos said. "When we counter that versus populations of higher socioeconomic status or the white race, for instance, those individuals usually catch us well within three to six months."

There are several factors at play. Black Americans traditionally have less access to insurance – let alone quality insurance -- allowing them allowing them to see a doctor at a post COVID clinic.

"So many of our patients that we've taken on have had to go through several insurance authorizations just to get a referral to come to us, and that's what they will say is part of their delay," Galiatsatos said.

Additionally, despite several clinics opening up across the country, Black patients are more likely to rely on public transportation, meaning less access to clinics. Galiatsatos said fewer than 10% of the patients he sees at the post-COVID clinic are Black.

Black households are also less likely to have internet. According to the Joint Center for Political and Economic Studies, 34% of Black adults in the U.S. do not have home broadband, meaning they may not have information about long COVID or know where to go to receive care.

What's more, a 2022 study found Black Americans make up about 15% of the U.S. workforce, but are much more likely than white Americans to hold frontline or essential jobs, accounting for 30% of bus drivers and 20% of food service workers, for example.

"A day missed of work is a day missed of income," Galiatsatos said. "If those patients have long COVID, they're going to decide between a paycheck and their health every day and that's not fair to them."

To close the racial gap in long COVID care, Galiatsatos recommends more regular implicit bias training among doctors and more telemedicine so patients can access specialized clinics.

Smith, the long COVID patient, said school buildings, historically black colleges and universities, churches and other community organizations can be used to educate Black communities on the effects of COVID and long COVID.

While Smith is able to cook and drive again, she still is unable to work and experiences several symptoms including brain fog, short-term memory loss, joint pain, gastrointestinal inflammation and headaches.

She hopes her story will help educate others and convince them to be their own advocate if they get pushback from physicians.

"This has been my reality for three years," she said. "I would rather be in a classroom with 40 kids, talking about how to write a great essay, than sitting here talking to you. Three years later, and I still get no comfort. I love telling my story to inspire other Black people and Black families, but I don't get any joy."

Copyright © 2023, ABC Audio. All rights reserved.

The science behind the zombie fungus from 'The Last of Us'

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(NEW YORK) -- The hit HBO series "The Last Of Us" describes a post-pandemic world devastated by a mass outbreak of a "zombie fungus" that infects and takes over the mind of its hosts. Originally a video game, the popular show was recently renewed for a second season.

Although its premise is science fiction, the fungus in the show is actually based in scientific reality.

Is the 'zombie' fungus real?

Cordyceps – the so-called "zombie fungus" – is a real fungus and is sometimes used in treatments and therapeutics in Chinese herbal medicine.

Although cordyceps does not infect humans, it does infect a wide range of insects.

In ants, cordyceps slowly infects its victims by mind-controlling the host to migrate to a humid climate where the conditions are perfect for its growth. Once a suitable environment has been found, the ant will dig its jaws into a plant and await death.

The fungus will then slowly consume the ant while eventually sending out its own spores – a sort of antenna to enthrall and trap future victims.

Could the 'zombie fungus' threaten human health?

There are thousands of species of cordyceps each designed to infect a particular species – luckily, humans aren't one of them. The human body's immune system is more advanced than that of an ant and has a higher internal temperature, which would protect it from cordyceps infection.

However, other fungi have made their presence known throughout human history. Ergot poisoning, also dubbed "St. Anthony's Fire," is caused by the contamination of grain and has been attributed to mass hysteria events such as the Salem Witch trials in the 17th century, Matthew Fisher, Ph.D., a professor of fungal disease epidemiology at the Imperial College School of Public Health, said.

While some fungi have been known to cause hallucinations on very rare occasions, "a human manipulating cordyceps is vanishingly unlikely," Fisher said.

Scientists said that while there are approximately 150,000 species of fungi – with a few million yet to be discovered – only about 200 are known to infect humans.

How do fungi currently affect human health?

Fungal infections are responsible for over 150 million severe cases and an estimated 1.7 million deaths per year worldwide, according to one study.

Researchers estimate that nearly a billion people have skin, nail and hair fungal infections annually. More serious fungal infections usually appear in people with other underlying health problems such as asthma, AIDS, cancer, organ transplant recipients and those on corticosteroid therapies.

In a detailed report, the World Health Organization warned in October, 2022, of 19 fungal pathogens representing the greatest threat to public health.

Yet, fungal infections receive less than 1.5% of infectious disease funding while killing more people than tuberculosis – a leading infectious disease killer worldwide.

"It's really shocking that research on fungal pathogens is so underfunded. Biohazardous threats are much broader than just bacteria and viruses," Jessica Malaty Rivera, infectious disease epidemiologist and research fellow at Boston Children's Hospital and The Johns Hopkins Center for Health Security, told ABC News.

Will there be a pandemic caused by fungal infections?

While some fungi can be transmitted from person to person, they generally do not spread as easily or quickly as viruses. Additionally, the human body's immune response and the availability of antifungal medications make it less likely that a fungus would be able to cause a global outbreak.

It is unlikely that a single fungus would cause a global pandemic on the same scale that we've seen with COVID-19. Viruses typically spread through respiratory droplets whereas fungal infections spread through direct skin-to-skin contact or from sharing items.

Despite a low possibility of spurring a worldwide pandemic, the global burden of fungal infections remains high. "Many of these infections can be incredibly difficult to treat and have high mortality rates," Rivera said.

Is climate change making things worse?

While it is highly unlikely climate change would lead to a zombie-like apocalypse according to experts, the warming of the globe continues to pose a threat to global health.

Research has shown that global pandemics from infectious diseases may become more common as habitats continue to bleed into one another and animals are exposed to species they have never interacted with before, while the space between humans and the natural world shrinks.

A new study also found that when scientists increased the temperature of a particular fungus was exposed to, the pathogen could adapt with certain genetic changes.

"These mobile elements are likely to contribute to adaptation in the environment and during an infection," postdoctoral researcher Asiya Gusa Ph.D. of Molecular Genetics and Microbiology in the Duke School of Medicine said in a press release accompanied with the study. The research may suggest that pathogenic fungi can adapt to the planet's warmer temperatures as well – highlighting the danger of global warming.

"It is clear that in a warmer wetter world, we are going to be exposed to more [fungi] than ever before – signs of this were seen during Hurricane Katrina – and this is going to pose an increased public health stress," Fisher said.

"If we are going to really tackle climate change, we have to get more specific about the impact it has on public health," Rivera said.

Copyright © 2023, ABC Audio. All rights reserved.

Eye drops recalled after 55 reports of bacterial infection, one death in 12 states


(NEW YORK) -- Two types of artificial tears eye drops have been voluntarily recalled following 55 reports of adverse use effects, including eye infections, vision loss and even a bloodstream infection that led to one death, according to federal officials.

The affected eye drops were distributed by Aru Pharma, EzriCare and Delsam Pharma under Global Pharma Healthcare.

According to a health alert released by the Centers for Disease Control and Prevention Wednesday, federal, state and local health agencies have identified at least 55 individuals -- some in health care facilities -- across 12 states who had been infected with a strain of Pseudomonas aeruginosa that expresses bacterial enzymes, making it highly resistant to many antibiotics.

Those impacted were in California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, Washington and Wisconsin.

Artificial tears are often used to relieve burning and irritation due to dryness of the eyes and provide lubrication while preventing further eye irritation.

"Use of contaminated artificial tears can result in the risk of eye infections that could result in blindness," Global Pharma Healthcare said in a recall statement posted on the U.S. Food and Drug Administration website Thursday.

"Global Pharma Healthcare is notifying the distributors of this product, Aru Pharma Inc. and Delsam Pharma and is requesting that wholesalers, retailers and customers who have the recalled product should stop use," the statement continued. "...Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to using these over-the-counter drug products."

The CDC issues similar guidance, stating that anyone who may have used EzriCare's artificial tears and suspects they have an eye infection should seek medical care. Signs of an eye infection may include discharge from the eyes, pain or discomfort, redness of the eye or eyelid, blurry vision, increased light sensitivity, a feeling of something in the eye, according to the CDC.

The CDC also recommended people reach out to their health care providers if they were using the eye drops under the care of a doctor.

EzriCare, one of the distributors of the impacted eye drops, has set up a website with information for consumers.

"We immediately took action to stop any further distribution or sale of EzriCare Artificial Tears. To the greatest extent possible, we have been contacting customers to advise them against continued use of the product. We also immediately reached out to both CDC and FDA and indicated our willingness to cooperate with any requests they may have of us," the company said in a statement.

The artificial tears were available over-the-counter online. The CDC, FDA and EzriCare are advising consumers to discontinue using any recalled eyedrops.

When reached by phone, Delsam Pharma president Kuppusamy Arumugam told "Good Morning America" the eyedrops Delsam distributed were recalled after the company was notified of a problem with Ezricare's eyedrops. Arumugam said any recalled eyedrops from Delsam can be sent back to the company for a refund.

According to the FDA, the recalled eye drops were packaged in bottles with safety seals and small cartons, with Ezricare drops having the NDC number 79503-0101-15 and UPC number 3 79503 10115 7, and Delsam Pharma drops labeled with the NDC number 72570-121-15 and UPC number of 72570-0121-15.

Consumers can direct questions to the distributors via email or phone. Aru Pharma and Ezricare can be reached at arupharmainc@yahoo.com or at@ezricare-info.com or at 1-518-738-7602 while Delsam Pharma is available at delsampharma@yahoo.com or 1-866-826-1306.

The FDA is also encouraging anyone impacted to file a report with the agency’s MedWatch Adverse Event Reporting program.

GMA has reached out to Aru Pharma for comment on the recall.

Copyright © 2023, ABC Audio. All rights reserved.

As US reels from Tyre Nichols video, what makes people act violently as a group?

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(NEW YORK) -- Many were stunned when videos were released of Tyre Nichols, a 29-year-old Black man, being beaten to death by five Memphis police officers during a traffic stop.

Officers pulled Nichols from his car on Jan. 7, pepper sprayed him and used a taser, the footage shows. He managed to flee, but the officers caught up with him and held him on the ground as they punched and kicked him in the head and hit him with a baton, according to the video that was released last week.

Seven Memphis police officers have been relieved of duty, with the five involved in the beating charged with murder. Additionally, three Memphis Fire Department personnel were fired.

While it's unclear what motivated the officers to act in that way, psychologists and other social experts told ABC News some people act differently in groups than when they are alone and may participate in group-based violence because of it.

Police may misperceive someone as a threat

George Smith, director of outpatient group therapy at McLean Hospital -- a psychiatric hospital in Belmont, Massachusetts -- said police group violence might be different from other forms of group violence because they may act when they view someone as a threat.

"I was just thinking about the five police officers, and they may have believed that there was an actual threat, either to the community or to themselves," he told ABC News. "Thinking this person is a menace to the community, and we need to do something to protect humanity from this genuine threat, or it may be that they believe that this person was a threat to one of them."

"And when that happens, your good judgment can go completely out the window," he added.

Smith said the person police officers might think to be a threat could be completely innocent, but the violence can still occur anyway.

"Even in a more benign situation, when a traffic cop pulls somebody over, it may be a completely innocent person whose taillight was out," he said. "But they don't know if this person has a weapon in their glove compartment so there's this unnatural tendency for them to get adrenalized and to approach the situation in a more belligerent way than was warranted."

Wanting to feel part of a group

Experts told ABC News wanting to belong to a group is nothing new and extends from wild animals running in a pack to humans wanting to affiliate.

While joining a group may have been necessary for survival in prehistoric times, it is now for developing a sense of camaraderie and belonging, experts said.

"As people are part of a group, they start to feel identified with this group, they feel like it's an important part of who they are, they might even come to define themselves in terms of being a member of a group," Dr. Rebecca Littman, an assistant professor in the department of psychology at the University of Illinois Chicago, told ABC News.

"There's different kinds of groups, some that are based on the premise of violence and others that are not," she continued. "So, you feel like you're very identified with this group, you want to be a good group member, you want to get along with everyone else. And that can lead kind of ordinary people who generally in their individual lives would never end up participating in violence."

Those same people, even though they know violence is wrong, may still participate because they'll feel shunned by the group if they don't.

"People are afraid of losing a social status, particularly when it's a group that they really care about," said Littman, who has studied why people participate in group-based violence. "They don't want to be ostracized or, even just in a less extreme form, they don't want to be seen as the odd person out."

Dr. Vivian Zayas, a professor in the department of psychology at Cornell University in New York, said if a person starts to go against what the group thinks, they might be seen as undermining the group.

"Strategically, there are consequences to people who don't work well in a group," Zayas told ABC News. "They can be left out of the group, they can be left out of decision-making, they can be marginalized, they could lose power and status. Those sorts of social punishments can be used to silence differing opinions."

Groups can normalize violent behavior

Research has shown that people's thoughts and actions are often influenced by how those around them think and act.

If a group normalizes a behavior, even if that behavior is bad -- such as violence -- then we might believe that behavior is acceptable.

"What can happen is that this group is creating this new set of social norms. Maybe in this group, we're often in situations where we feel a lot of threat and we have to protect ourselves, and the way we protect ourselves is violence," Littman said.

"So, you can kind of see how that violence in particular groups can become normalized in a lot of different ways and make people either themselves genuinely feel like it's okay or at least feel like this is what is normal in my group," she added.

Leaders can influence behavior

The experts told ABC News that because we are influenced by leaders -- and leaders set examples for the group -- if the leader believes in bad behavior, the group may follow.

"If that person has status in that group and if they're saying that the behavior is appropriate for group members -- even if initially, someone thought that the behavior is problematic -- they might feel that or come to think that it's more appropriate," said Zayas.

Zayas added that someone in the group might also see that the leader was elevated by engaging in problematic behaviors and wasn't punished or reprimanded so they think they can also engage in the behavior without getting in trouble.

Reports have emerged that Memphis Police Chief Cerelyn Davis adopted a "tough on crime" strategy when she took on the role.

Part of that included launching the SCORPION unit, which stands for Street Crimes Operation to Restore Peace in Our Neighborhood, of which the five officers were members. Activists and residents have said members of the unit used excessive force. The unit has since been disbanded.

"The process of listening intently to the family of Tyre Nichols, community leaders, and the uninvolved officers who have done quality work in their assignments, it is in the best interest of all to permanently deactivate the SCORPION Unit," a statement from the department read.

This doesn't mean that Davis advocated the use of violence nor that she encouraged her officers to be violent, but the officers may have felt they were fulfilling her mission, experts said.

"So, it became part of a shared mission and when you get that mission, and there's buy-in, because you're part of a group that believes this mission," Smith said. "One's ability to discern whether it actually is a perceived threat can get totally overshadowed by this belief that we together are saving the community from these threats that are out there."

In a video posted on Jan. 26, Chief Davis condemned the officers' actions and called the circumstances surrounding Nichols' death "horrific."

“I am not wavering in my commitment to you to have a police force that is here to serve and protect you," she said. "Those five officers and others failed our community and they failed the Nichols family and that is beyond regrettable.”

Copyright © 2023, ABC Audio. All rights reserved.

How long eggs stay fresh, tips to store them and how to check if eggs are still safe to eat

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(NEW YORK) -- Shoppers have seen significant price spikes on eggs as of late and since everyone wants to make the most of their hard-earned money, there are a few simple rules and tricks you should know to prevent prematurely tossing or wasting the staple protein.

Most egg cartons sold in stores get stamped with a "best if used by" or "best before" date for stores to control and rotate inventory. The U.S. Department of Agriculture explains that the printed "expiration date" is there so consumers know how long the eggs will be at their highest quality and best taste when stored in ideal conditions.

"Use by" dates show shoppers how long they have to consume the eggs before their overall quality diminishes. According to the USDA, the "use by" date "may not exceed 45 days including the day the eggs were packed into the carton."

However, in many cases eggs can still be safely consumed beyond that date if they aren't spoiled.

Eggs can last up to five weeks after they were packed, when stored in proper refrigerator conditions, according to The American Egg Board.

Here are some Grade A tips from the USDA to keep in mind when you need to know if you still have a good egg:

How to properly store store-bought eggs

Eggs purchased at the store should be brought straight home and refrigerated immediately at 40 degrees or colder, the USDA advises: "Keep them in their carton and place them in the coldest part of the refrigerator, not in the door."

Typically, the coldest part of the fridge is lower shelves and towards the back of the unit.

Due to risk of bacteria growth and salmonella, don't leave store-bought eggs out of the refrigerator for more than 2 hours. Any bacteria present in an egg can multiply quickly at room temperature, according to the USDA. When a cold egg sweats at room temperature, it can cause bacteria to move into the egg and spread more easily.

How long are eggs good once cracked?

Because bacteria can enter eggs through cracks in the shell, the USDA says to never purchase an egg that's cracked.

"If eggs crack on the way home from the store, break them into a clean container, cover it tightly, keep refrigerated, and use within two days," the agency states. "If eggs crack during hard cooking, they are safe. Remember that all eggs should be thoroughly cooked."

How to use water to test if eggs are still fresh

Despite a "best by" or "packed on" date -- or if you have a couple extra eggs out of their carton in the fridge and don't remember when they got there -- this sink or float test is a good baseline to determine if an egg is still fresh.

First, fill a bowl with enough cold water to cover the egg, and gently lower the egg in.

If it sinks to the bottom and stays on its side, the egg is very fresh, according to The Spruce Eats, which regularly tests common kitchen and cooking tricks like this one.

An egg that sinks to the bottom but floats on an angle or upright is slightly older but still safe to eat.

Eggs that float completely should be discarded as they're too old to safely consume, The Spruce Eats notes.

As eggs age, the shell becomes more porous so more air is able to flow through and can create a larger air pocket between the egg membrane and shell. That small sack of air, once large enough, is what makes the egg float.

How long do you have to safely eat eggs once cooked?

Cooked eggs and dishes made with eggs should be eaten immediately after cooking. They can also be stored in a shallow container for quick cooling and then refrigerated for later use within three to four days.

When it comes to hard boiled eggs, the USDA states that the shell's protective coating, or "bloom," which is produced by a hen when it lays an egg, gets washed away "leaving bare the pores in the shell for bacteria to enter and contaminate it."

For that reason, the USDA recommends hard-cooked eggs be refrigerated within two hours of cooking and used within a week.

How long do farmers market eggs stay fresh?

Because farm stands and farmers aren't bound by the same USDA requirements to be washed, these eggs are often sold unrefrigerated and protected by their bloom.

According to The Happy Chicken Coop -- an online publication and "group of chicken enthusiasts from around the world who have been raising chickens in their backyards for decades" -- farm fresh eggs can be left unrefrigerated for up to a month, though after that, should be stored in a refrigerator, where they can be kept for up to six months.

Freeze raw eggs to use later

Yes, you can freeze eggs, just not in their shell because they will expand and break. So if you know you won't finish an entire carton before the expiration, this is a great way to cut down on food waste.

According to The American Egg Board, there is a simple way to freeze eggs.

Crack the eggs into a bowl, gently whisk until whites and yolks are combined (not so much that air is introduced), and pour the eggs into an ice cube tray to freeze in individual servings. One cube is approximately half an egg. Once the cubes are frozen solid, transfer from the tray into a freezer-friendly, air-tight plastic bag.

Chef Jürgen David, director of pastry R&D at the Institute of Culinary Education, told ABC News' Good Morning America that he suggests separating the whites from the yolks first "because many pastry applications call for just yolks or an unequal amount of yolks and whites."

Gently beat the yolks until it forms a liquid and freeze and store as explained in the first method. One cube equals two egg yolks.

For the whites, pour directly into an ice cube tray, then freeze and store accordingly.

Frozen eggs keep best for two to three months, but can last up to a year in the freezer.

When ready to use the frozen eggs, thaw them in the refrigerator overnight or under running cold water and use them as intended.

Copyright © 2023, ABC Audio. All rights reserved.

A public health success story: How the Mpox crisis was controlled within 6 months

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(NEW YORK) -- When the highly infectious Mpox virus, formerly called Monkeypox, was declared a public health emergency in August of last year, more than 450 people were testing positive every day. With more than 30,000 cases and 28 deaths, many feared Mpox could become the next pandemic.

The virus -- characterized by a painful rash and deep lesion -- was primarily spreading via skin-to-skin contact among sexual networks.

Now, roughly six months later, the emergency is over, with the nation averaging fewer than three cases per day. According to doctors and public health experts interviewed by ABC News, the virus didn't disappear on its own. Instead, the virus was controlled through an aggressive, highly coordinated public health response.

"Mpox is a success story of conquering an outbreak," said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco.

The successful control of Mpox was due largely to the rapid deployment of vaccines and treatments paired with an aggressive public awareness campaign that leveraged trusted voices in the LGBTQ community, which was hit first by the outbreak.

"Of course there have been criticisms," said Dr. Vincent Hsu, an infectious disease specialist and AdventHealth's infection control officer. "But the fact remains that in a relatively short period of time, we have been able to get the number of cases down to where there's just very few."

Key to that success was public outreach and education.

"Health departments and community advocates got the message out about Mpox -- how the disease presented, how it was spread, how it could be treated and how it could be prevented, including vaccination," said Dr. Roy M. Gulick, chief of the Infectious Diseases Division at Weill Medical College of Cornell University. "The sharp decrease in cases directly resulted from these efforts."

Public health experts credited a strong, unified response from leaders in the LGBTQ community. In fact, the rapid response in the LGBTQ community did not allow the virus to spread even further, Hsu said.

"The LGBTQ community has a strong record of community advocacy and successful interactions with the public health system from the time of the HIV epidemic," said Gulick. "Education led to behavior changes in the community, including limiting the number of sexual partners, as well as the enthusiastic uptake of the vaccine."

"Some of the secret sauce came around communication," added Chin-Hong, including "using trusted messengers from the community" to deliver the message. Chin-Hong pointed to Reggie Aqui, an ABC anchor in San Francisco and an openly gay man, as an example. Aqui was nominated for a GLAAD award for his work and community discussions about Mpox.

Another smart move was appointing Dr. Robert Fenton and Dr. Demetre Daskalakis to head the federal government's MPox response, Chin-Hong said. Fenton and Daskalakis deployed evidence-based guidelines which helped doctors like him feel comfortable trusting their advice, he said.

Beyond education, an equally crucial factor in controlling the outbreak was the rapid deployment of existing vaccines and treatments that had been stockpiled for smallpox, a closely related virus.

"The prior availability of therapeutics meant we weren’t flying the plane as we were building it," said John Brownstein, an ABC News contributor and chief innovation officer at Boston's Children's Hospital.

In August -- with limited supplies of the only FDA-approved mpox vaccine -- government public health officials made a controversial choice to break up a single vaccine into multiple doses, tweaking the route of administration to maximize the body’s immune response.

Thankfully, this new vaccine strategy worked -- as did existing treatments, according to doctors and public health experts.

Still, experts warn the virus hasn’t been fully eradicated and could return. Although "the emergency is largely over," Hsu said, "we need to continue to be vigilant."

"The Mpox response is now a model by which to prepare for future infectious disease threats," Brownstein said.

Added Chin-Hong: "I think Mpox generally provides a great playbook of how to deal with an outbreak: the alignment of science and politics needed, a national a local strategy that was implemented and having strong and unified consistent messaging that is empathic and specific."

Copyright © 2023, ABC Audio. All rights reserved.

FDA issues warning letters to companies selling unproven mpox treatments

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(NEW YORK) -- A new warning from the Food and Drug Administration urges consumers to beware of marketers attempting to sell illegal and unproven mpox "medication" and "cures" in order to swindle scared, vulnerable people and bilk them out of their money.

The agency also shared a series of pictures of the alleged illegal products for sale.

These products, often sold online, have not been reviewed by FDA, the agency says, and are not proven safe or effective to treat mpox and other health conditions that they claim to address.

Several warning letters have been sent by FDA to the companies allegedly peddling these products.

One company's website falsely claims that an "herbal natural remedy" for mpox comes from the carnivorous purple pitcher plant, Sarracenia Purpuria, the agency said.

"For decades, research has shown the effectiveness of Sarracenia Purpurea (Pitcher Plant) against past outbreaks of small pox [sic] in the 19th Century, found to halt viral replication in viral, derived from the Variola Virus also associated with Monkey Pox," the company's site says, according to FDA's warning letter.

FDA notes that site also uses additional metatags and social media posts with key terms like "Monkey Pox," "Herbal Natural Remedy" and "remedy coming soon!" to bring consumers to their site for purchases.

Another company's site, which appears to target young parents, allegedly falsely claims that colloidal silver can help fight viral infections -- not only mpox, but also COVID-19, RSV and other upper respiratory tract infections.

The FDA quotes this company as saying on its website, "What Can Colloidal Silver Treat? … As an antiviral, silver can kill the virus that causes COVID-19 and may be an effective adjunctive treatment. There is also evidence that it may be effective against other viruses of interest including monkeypox, herpes, RSV, and viruses that cause upper respiratory tract infections (like influenza)."

Claims like these are particularly concerning in light of their appeared marketing toward infants and children, the agency says -- with marketers allegedly preying on parents' scrambling to take care of their kids after a difficult fall and winter when pediatric patients were slammed hard with the tripledemic of RSV, Covid, flu and other viruses -- amid notable shortages of the cold, fever and cough medications which are actually approved to help their symptoms.

The FDA said it's "particularly concerned" that the second company marketed their colloidal silver product "for use in infants and children," the letter says. The agency singled out a blog post for parents that advertised the product as tasting "like water and is easy to give to even the pickiest kids."

"The use of untested drugs can have unpredictable and unintended consequences, especially in vulnerable populations such as children and infants who may be at greater risk for adverse reactions," the FDA said, since their bodies absorb and metabolize drugs differently.

Health experts say the best way to get medical care for mpox -- or any other malady -- is to speak with your healthcare provider. Wellness products aren't rigorously tested and don't have great oversight, especially on the internet -- something which marketers know they can take advantage of, according to experts.

Copyright © 2023, ABC Audio. All rights reserved.

Is Ozempic safe to take during pregnancy or while trying to conceive? Experts weigh in

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(NEW YORK) -- The growing popularity of drugs like Ozempic, Mounjaro and Wegovy, designed to help people with Type 2 diabetes and obesity, has raised new questions about what those drugs could mean for pregnancy and fertility.

The medications, all brand names for a compound called semaglutide, have grown in popularity thanks to reported use by celebrities and posts from everyday people on social media about successful weight loss, many from women of childbearing age.

Given as a daily oral medication or weekly injection, drugs like Ozempic, Mounjaro and Wegovy, called GLP-1 RAs, help people produce insulin and lower the amount of sugar in the blood.

They also work by slowing down movement of food through the stomach and curbing appetite, thereby causing weight loss.

Side effects of the drugs can include severe nausea and constipation.

Because semaglutides are relatively new on the market -- approved by the Food and Drug Administration within the last five years to treat Type 2 diabetes and obesity -- there is still research to be done on exactly how they impact women of childbearing age, experts say. In addition, people who don't have diabetes or obesity can still be prescribed the drugs "off-label," which may have different impacts.

ABC News' Good Morning America spoke with two experts who shared the latest on semaglutides and pregnancy.

Are Ozempic and other semaglutide medications safe to take during pregnancy?

No, according to Dr. Amanda Velazquez, director of obesity medicine in the Department of Surgery at Cedars-Sinai Medical Center in Los Angeles.

"This class of medications are not recommended for women who are pregnant," Velazquez told GMA. "There have not been any studies that have been conducted to test these drugs in women who are currently pregnant, so they're not at this time recommended."

The FDA also says in its safety profiles of Ozempic, Wegovy and Mounjaro that they should not be taken during pregnancy, noting there is "insufficient data" available.

The FDA also explains that the drugs could cause weight loss, and that "weight loss offers no benefit to a pregnant patient and may cause fetal harm."

Velazquez noted that in addition to there not being enough human research to show GLP-1 RAs are safe during pregnancy, animal studies have shown complications.

"For a human, what's the effect on baby or mom? We don't know," she said. "However, from animal studies we know that animals that were on these medications and pregnant, it reduced the embryo size and it can cause abnormalities, developmental abnormalities, for the developing fetus."

How long do you have to be off a semaglutide medication before getting pregnant?

The FDA recommends that people discontinue semaglutide treatment at least two months before they plan to become pregnant.

Dr. Sarah Lassey, a board-certified OB-GYN and co-director of the diabetes in pregnancy program at Boston's Brigham and Women’s Hospital, said that window of time allows the medication to leave the body.

"We know that these medications can kind of be in your body for a longer period of time," Lassey told GMA. "So we recommend transitioning off of this class of medication essentially two to three months prior to when you plan to start getting pregnant."

Going off of the medications should be done under the supervision of a medical provider, just as when you start the medications, according to both Lassey and Velazquez.

Is the risk of semaglutides and pregnancy atypical?

No, according to Velazquez.

"This is a very standard risk," she said. "These drugs are like drugs in other medical classes that we use in the sense that you shouldn't be looking at these as unique."

Velazquez said the medications for Type 2 diabetes and obesity should not be looked at differently than other drugs that a person would take for heart disease or high blood pressure, for example.

"It's not the drugs, it's that we see them as an option versus something that's medically necessary," she said, "when really this is medically necessary for many patients who find it difficult to lose weight, and that's 70% of the population who are overweight or obese right now."

Why would a person who wants to become pregnant take a semaglutide medication?

Drugs like Ozempic, Mounjaro and Wegovy can be very effective in helping people lower their blood sugar levels and get to a healthy weight, which can be critical for a healthy pregnancy, according to Lassey.

"We know that poorly controlled diabetes during pregnancy is associated with both maternal and fetal outcomes in a pregnancy," she said, noting those risks can include miscarriage, birth defect, stillbirth and preeclampsia. "Our way to prevent any of these adverse outcomes is to control blood glucose levels and hemoglobin A1c in the time prior to conceiving as well as throughout the pregnancy."

Lassey said that while the medications aren't recommended generally for people who want to become pregnant in a short amount of time, for others, they can be lifesaving.

"If you're a 20 to 30-year-old with diabetes and obesity, potentially, I think these classes of medications have really significant benefit for improving your blood sugar values and improving your overall cardiovascular profile," she said. "So we'd recommend those medications knowing that down the line, if and when you were to conceive, we would have to change those medications."

Do semaglutide medications impact fertility?

Lassey said there is not enough long-term research at this point to know how the medications may impact fertility.

"We just don't know," she said, adding, "However, we know that when people have better blood sugar control and things like that, they have lower rates of miscarriage and improvement in their fertility, typically."

What to do if you get pregnant while taking a semaglutide medication

A person who becomes pregnant unexpectedly while taking a semaglutide should contact their healthcare provider, who can help them transition off the medication and make sure they are receiving proper maternal care.

The FDA also says on its website that there will be a "pregnancy exposure registry" that monitors outcomes in women "exposed to semaglutide during pregnancy," and says pregnant women who are impacted and healthcare providers should contact the drug's manufacturer.

Can you take a semaglutide medication while breastfeeding?

No, the medications have not been proven to be safe while breastfeeding, according to both Lassey and Velazquez.

"The data about breastfeeding, even about the availability of whether or not you can find these drugs in the breast milk, is very limited," Lassey said. "It just hasn't been studied yet, so we wait to initiate these medications until patients report that they have stopped breastfeeding."

Both doctors also said that knowing that the medications will need to be stopped during pregnancy and breastfeeding should not prevent a person from considering them.

"This shouldn't be a barrier to one trying out these drugs if they qualify and if they think this would be a good adjunct to their treatment plan from their healthcare provider," said Velazquez. "What we do is we start the drug, in conjunction with a healthy lifestyle plan, we help them lose weight, improve their weight-related medical conditions and optimize their health for a healthier pregnancy and a healthier overall being ... and then you [can] resume the medication once you're done breastfeeding."

Copyright © 2023, ABC Audio. All rights reserved.

If fentanyl is so deadly, why do drug dealers use it to lace illicit drugs?

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(NEW YORK) -- With the nation still in the grips of an opioid epidemic that began decades ago, the crisis has deepened in recent years with the introduction of fentanyl, a synthetic opioid that is up to 100 times more potent than morphine.

The driving force behind a record-breaking 100,000 overdose deaths per year, fentanyl is now being laced in traditional opioids like oxycodone and heroin, and increasingly, in non-opioids like cocaine and various counterfeit pills.

But with its high death rate, why would drug dealers lace drugs with fentanyl, effectively killing off their potential customers?

According to experts, there are many reasons fentanyl has become such a widely used illicit drug, despite its high overdose potential.

Fentanyl is not always a death sentence

Fentanyl isn’t just a street drug. It is also a legal painkiller than can be given safely under the right circumstances.

When it comes to why some people overdose after taking fentanyl and some do not, it’s really “the fluctuation in purity that makes it unpredictable and deadly,” according to Nabarun Dasgupta, PhD, epidemiologist at the University of North Carolina at Chapel Hill studying opioids.

According to law enforcement officers and former drug dealers interviewed by ABC News, drug dealers often think they can mitigate the risk for their clients by measuring the fentanyl carefully.

Done correctly, lacing illicit drugs with fentanyl often creates a return stream of customers because fentanyl is considered highly addictive. This is why fentanyl is often found in drugs like cocaine, counterfeit Xanax, counterfeit Adderall, or other drugs not classified as opioids.

“Fentanyl is good for business if you layer addiction into it,” Dasgupta said.

Fentanyl is a cheap alternative to other opioids

A fraction of fentanyl could mimic the highs of other opioids, like heroin or prescription painkillers. Dealers will often use simple binding agents and a small amount of fentanyl when making counterfeit opioid pills or what they say is heroin, according to law enforcement.

Because a smaller dose has a similar effect relative to other opioids, it is also easier to smuggle.

Eric Falkowski, an incarcerated former fentanyl dealer interviewed by ABC News, claimed he could make over ten times the amount of counterfeit opioid pills with a kilo of fentanyl rather than with a kilo of traditional components.

Fentanyl production does not have tight quality control

Legal pharmaceutical products are manufactured with safeguards in place to ensure quality control. Drug dealers may not have professional chemistry skills and may not have quality control tests, which means that small mistakes when mixing the drug can be fatal.

“Street drugs have gotten a lot more variable since the start of the pandemic. Now you have mom and pop shops making street drugs - that creates disincentives for stability and control,” Dasgupta said.

In a phone interview with ABC News from prison last year, Falkowski spelled out his process and blamed the death in Tennessee on faulty equipment/mismanagement.

“I felt like I could mitigate some of the dangerousness by using better manufacturing techniques […] and that worked for a long time.” He said, adding that the Tennessee overdose outbreak caused by his counterfeit pills “really came from some inadequate procedures and equipment."

Falkowski was ultimately convicted and sentenced to up to 25 years in prison in 2018 for intentionally adding fentanyl to counterfeit pills that resulted in someone's death and over a dozen near-fatal overdoses in Murfreesboro, Tennessee.

Overdose deaths usually lead to investigation by law enforcement, which is bad for business and can often result in the dealer's arrest. However, the drug is so profitable that it's worth the risk. Falkowski told ABC he was able to have "a pretty long run” selling drugs laced with fentanyl before his pills killed someone.

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How a different therapy is being used to treat 10-year-old Uvalde shooting survivor

Gladys Gonzales and her 10-year-old daughter Caitlyne Gonzales. - Courtesy of Gonzales family

(UVALDE, Texas) -- Gladys Gonzales says she felt the urgent need within hours to find mental health services for her 10-year-old daughter, Caitlyne Gonzales, who survived the massacre at Robb Elementary School in Uvalde, Texas.

"I came home to the realization of what had transpired, and it hit me that they had undergone a terrible, terrible thing, and so I knew right then and there that she was going to need in-depth therapy," the mother told ABC News.

Nineteen children and two of their teachers were shot to death by an 18-year-old shooter, a former student, who attacked the school on May 24, 2022. Caitlyne's best friend, 9-year-old Jackie Cazares, was one of the children killed.

Caitlyne has been outspoken since the shooting and has advocated for gun reform. She traveled to Washington, D.C, in December and called for an assault weapons ban to be passed on Capitol Hill.

"I decided to be a voice for my friends who can't use their voice no more," Caitlyne said at the time.

Gonzales said her daughter went through several traditional cognitive behavior therapists for post-traumatic stress disorder, but Caitlyne had a difficult time making progress and instead began "regressing." Gonzales says she even brought her daughter to the Uvalde Together Resiliency Center, a site for long-term mental health services offered by Uvalde County officials and Texas Gov. Greg Abbott, however, Gonzales said the services weren't effective for Caitlyne.

Gonzales said that as Caitlyne began to regress, she lost interest in her favorite activities, became more isolated, and more paranoid about the thought of losing her mother.

It was last summer that Gonzales says she took Caitlyne to a grief camp in San Antonio and met a counselor who suggested Caitlyne try a form of therapy called eye movement desensitization and reprocessing, or EMDR.

The American Psychological Association describes EMDR as an eight-phase treatment in which patients "briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation." The bilateral stimulation is typically done with side-to-side eye movements or other rhythmic stimulations like taps or tones. This treatment causes a reduction in the "vividness and emotion associated with the trauma memories."

According to a spokesperson for the APA, EMDR is "conditionally recommended" in their 2017 Clinical Practice Guideline for the treatment of PTSD and "evidence that indicates that they can lead to good treatment outcomes."

In an email to ABC News, a spokesperson for the World Health Organization said that EMDR can be an effective treatment for children and is a recommended option for PTSD in the WHO guidelines.

Danielle Brown, an associate professor of social work at the University of Southern California and a licensed clinical social worker and psychotherapist who uses EMDR in her private practice, said that in simpler terms, EMDR "re-files" traumatic memories and allows the brain to make new connections around them.

"We're not wiping out memories, but we're reprocessing and reintegrating them with more positive—more kind of clear-eyed associations—so that it's something that you'll remember but it won't trigger the same emotional or physiological response that we see in PTSD," Brown said in an interview with ABC News.

Gonzales says Caitlyne's struggles with talk therapy caused some of those emotional and physiological triggers, but in addition to this, Gonzales recalled one specific example in which she says a cognitive behavioral therapist dismissed her concerns.

"That therapist—after one session—told me, 'There's nothing wrong with her,' those were her words and I was just shocked," Gonzales said.

But Gonzales knew better since Caitlyne opened up to her about how she was feeling, and she says she also began experiencing night terror, which left Caitlyne unable to sleep alone because of excruciating fear. Gonzales also attributed her current graduate studies in counseling at Sul Ross Rio Grande College, and her previous work as a mental health caseworker for children who had severe emotional disturbance.

Caitlyne was officially diagnosed with PTSD in December, Gonzales said.

Gonzales said she had never heard of EMDR prior to the grief camp's recommendation, and after an arduous approval process and waitlist, Caitlyne finally started EMDR therapy in San Antonio in January.

"I made a promise [the day of the shooting] that I would help my daughter the best to my ability, and if it's driving an hour and a half to two hours to get her the appropriate health services, then so be it," she said.

The 10-year-old survivor immediately expressed her satisfaction after the first session and her mom said she is finding success so far with EMDR.

Brown, who does not treat Caitlyne, said she is not surprised to hear about the trajectory of Caitlyne's therapy.

"A lot of CBT approaches have you retell or recount the story start to finish, which is problematic in a couple of ways," Brown said. "If you don't have the language for the experience—which often happens in trauma because our language centers can turn off during a trauma—you'll hear victims sometimes say, 'I don't have the words,' or 'I can't articulate it,' because literally the language isn't there, so there's not a cohesive narrative to describe."

"The other problem is that sometimes recounting the details, that in itself is re-traumatizing," she said. "So with EMDR, we approach it from a different way. You don't have to have all the words and you don't have to have all the memories for it and you don't have to retell the story and relive it as we're reprocessing the events or the memory."

Gonzales said she now aspires to become an EMDR therapist and hopes that spreading awareness about her daughter's experience will help inform other families dealing with PTSD.

"If a therapist doesn't work for your child, don't stay there, move on to the next one until you do find the correct therapist for your child," she said. "For kids going through PTSD and trauma, it's so important because they already have these risk factors in the future, and I would hate for them to fall into the cracks just because they didn't receive appropriate treatment."

Even though CBT did not work for Caitlyne, it still remains one of the recommended interventions for PTSD, according to the APA.

Copyright © 2023, ABC Audio. All rights reserved.

Excessive screen time during infancy may be linked to lower cognitive skills later in childhood

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(NEW YORK) -- The amount of time babies spend watching computer, TV and phone screens in their first year of life may be indirectly linked to lower cognitive skills later in life, according to a new study.

Babies who watched on average two hours of screen time per day performed worse later on, at age 9, on executive functions, according to the study, which was published Monday in the journal JAMA Pediatrics.

Executive functions, linked to long-term academic success, are defined by the study's researchers as "a collection of higher-order cognitive skills essential for self-regulation, learning, and academic achievement, as well as mental health."

The researchers studied more than 400 children.

"They did EEGs to test and study brain waves at about 18 months and then connected the dots between how much screen time they were seeing in infancy to how they performed on memory and attention tests around the age of 9," explained Dr. Jennifer Ashton, ABC News chief medical correspondent, who was not involved with the study. 'What they found was that the babies who had the most screen time ... did the worst on attention and memory testing by age 9."

The study did not prove that screen time directly leads to lower cognitive functioning. Other factors, such as a family's income level, also seemed to be linked to lower cognitive functioning scores.

Nevertheless, the findings track with guidance from the American Academy of Pediatrics that children under the age of 2 should not have any screen time.

The AAP recommends that children between the ages of 2 to 5 be limited to just one hour of screen time per day that is supervised by a caregiver.

More than 75% of children younger than 2 and 64% of kids ages 2 to 5 exceed the recommended guidelines, according to researchers at the University of Calgary, who analyzed over 60 studies looking at more than 89,000 children around the world.

Above the age of 5, the AAP says parents should set boundaries on screen time and work with their children to create a Family Media Use Plan that sets time limits and establishes guidelines on the type of media children are consuming.

"There are some studies that suggest with older children, particularly adolescents, that there could be some social or emotional advantages," Ashton said. "So it’s really not only how much, it's what our teenagers and children are consuming on the screen that really makes a big difference."

Earlier this week, U.S. Surgeon General Dr. Vivek Murthy made headlines by saying he believes 13 is too young for children to be on social media platforms, despite some of the most popular platforms, including Facebook and Instagram, setting that as their minimum age requirement.

Social media use has been linked with symptoms of depression and anxiety, body image issues, and lower life satisfaction for some teens and adolescents, research shows. Heavy social media use around the time adolescents go through puberty is linked with lower life satisfaction one year later, one large study found.

Not every teen has those experiences. Researchers are still working to understand who is most at risk of negative effects from social media, and it's not clear yet if there are differences in mental health effects based on when kids first start using social media.

For parents trying to navigate guidance around social media and screen time with their kids, Ashton shared these four tips:

1. No phones at the table for meals or family gatherings.

2. Stop screen time one hour before bedtime.

3. Keep phones and screens out of the bedroom when sleeping.

4. Lead by example as parents by limiting your own screen time and social media use.

Copyright © 2023, ABC Audio. All rights reserved.

What the end of the COVID-19 emergencies in the US means

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(NEW YORK) -- On May 11, the U.S. will no longer officially be in a COVID-19 emergency for the first time since the pandemic began three years ago.

While hundreds of COVID-19 deaths are still reported each day in the U.S. -- adding to a toll of more than one million -- public health experts said the Biden administration is likely looking to end the national and public health emergencies related to COVID-19 because the omicron subvariants that are circulating are producing milder disease and the U.S. has high levels of immunity from previous vaccinations or infections.

The threat of the virus has also receded for many Americans, thanks to testing, treatments and vaccines.

Jen Kates, with the nonpartisan nonprofit Kaiser Family Foundation (KFF), called the end of the emergencies "symbolically a big change." But it will also alter systems that people have come to rely on without realizing they were temporary, at the same time that experts say that it's unclear what the future will hold.

"I think the administration is hoping that we are clearly transitioning into an endemic period, and that the pandemic period is in the past," Dr. William Schaffner, a professor of preventive medicine at the Vanderbilt University Medical Center in Nashville, Tennessee, told ABC News.

"Now, that said, those of us in infectious diseases and public health are a little nervous. And the reason is, here we are at the end of January predicting what the circumstances will be in May," Schaffner added. "This is a very unpredictable virus."

Here are the biggest impacts of the public health and national emergencies ending, according to experts:

Millions could lose Medicaid

After three years of major enrollment increases for Medicaid, anywhere from five to 14 million Americans could soon lose their access to the government's health insurance program for low-income people and others, according to KFF, which focuses on national health.

And according to estimates from the U.S. Department of Health and Human Services, nearly seven million of these people could still be eligible but will fall through the cracks of the renewal process and lose their health insurance.

For context, almost 20 million people enrolled in Medicaid during the COVID-19 public health emergency, an increase of nearly 30% since before the pandemic, and uninsured rates dropped to record lows.

That increase was fueled by a rule under the public health emergency that barred states from removing anyone from Medicaid while the pandemic was at its worst -- allowing people to avoid the bureaucratic renewal processes that experts said could often lead to people losing their coverage even when they were still eligible.

But a recently passed law in Congress returned the right to states to disenroll people from Medicaid beginning on April 1, ending the continuous enrollment afforded to people during the public health emergency.

"This is going to lead to people who are eligible for the program losing out," said Kates, a senior vice president at KFF. "And so I think this is a concern right now, because they would lose coverage for all of their health care during that period."

In the year after the Medicaid rules change, KFF estimates that enrollment will decline between 5% and 13%.

There are efforts to catch some of those people who lose their Medicaid insurance, like a special open enrollment period through the Affordable Care Act.

And some Americans will be disenrolled from Medicaid because they get a job that offers health insurance instead -- or because they then are making too much money to qualify for Medicaid.

"As a person on the street, I understand where the government is going. But as a physician, I'm a little bit worried, because [losing Medicaid] makes a difference between the haves and have nots," Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, told ABC News.

"Particularly with a price tag of $500 for a Paxlovid course [to treat COVID-19], $130 for a shot, we already know how much testing costs for going to Walgreens and CVS," he continued. "So I think all of these things together makes it difficult for everyone to protect not only themselves but each other."

New COVID costs for tests and treatments

The end of the public health emergency will mean that Americans start paying more for certain COVID-19 health measures, but the increase likely won't all be felt at once.

One of the most obvious new costs will be at-home rapid tests, which have been free for most of the time they've existed. People can get eight free tests a month covered by their insurance, for example, or order free tests in the mail from the government.

But that ends with the public health emergency on May 11, Kates at KFF said. The same is true for walking into a clinic or doctor's office to get a test. That could come with costs in the future, whereas it is free under the emergency order.

As for treatments, like the antiviral Paxlovid, that will depend on when the federal government's supply runs out, at which point insurance companies will change their policies. Until then, people will likely not see a huge cost increase on treatments.

"The federal declaration has big implications, mainly financial, that many people don't even realize," Chin-Hong said.

"All of a sudden, you have to be paying for copays and office visits, or even lab tests," he added. "And then people may not want to seek health care because they are afraid of paying some sort of copay or being saddled with a huge bill."

But vaccines will remain free for people with insurance. Because of work in Congress and by the Centers for Disease Control and Prevention, COVID-19 vaccines are mandated to be covered by insurance -- through the end of the public health emergency and even once the government stops buying and distributing them for free.

Telehealth access remains through Medicare

Congress moved to ensure telehealth access for all Medicare recipients for the next two years, so the audio and video visits that those patients have come to rely on are not threatened by the end of the emergency.

As for people on private insurance, telehealth access will depend on state laws and insurance company policies. People can check with their providers for more information, as there's no one-size-fits-all answer.

Pandemic data may be harder to track

The public health emergency mandated that states share certain data with the CDC, like COVID-19 case counts and deaths. Though a senior Biden administration official said that the CDC will continue to encourage states to voluntarily share that information with them, some states will choose not to.

The result could be a cloudier picture of the pandemic, including less insight into possible infection surges and slower responses from health officials.

"It means that we won't be able to track simple things like hospital capacity," Chin-Hong said.

"So there'll be less ability to sound the alarm before the storm comes essentially," he said.

Schaffner, the professor of preventive medicine, said that the end of all the emergency measures will signal to the public that the pandemic is over -- when infections and deaths continue.

"Somewhere between 300 to 500 people die of COVID in the United States daily, at the present time," he said. "So we're going to have to keep our guard up. But if we declare an official end, I think the general public will hear that as a message that they don't have to worry about it anymore and that may lead, as you can imagine, to an increase in COVID."

Title 42 is still up in the air

The end of the COVID-19 emergencies is linked to a very different issue -- immigration.

The public health emergency has allowed both the Trump and Biden administrations to cite Title 42 of federal law to quickly expel migrants seeking asylum from the border based on the threat of spreading COVID-19.

While the Biden administration is now seeking to end Title 42, a group of mostly Republican-led states wants to keep it in place, arguing they would be harmed from the resulting immigration.

The issue is before the Supreme Court. Their decision will come sometime before June, when the court's term ends.

Student loan debt cancellation may get more complicated

Ending the COVID-19 emergencies could legally complicate the position the Biden administration has taken while arguing it has the ability to cancel government-held student loan debt for some 40 million Americans.

That plan has been challenged in court and goes before the Supreme Court next month.

The administration has been using the COVID-19 national emergency as justification for the secretary of education's authority to change the status and terms of the student debt.

"There was a national emergency that impacted millions of student borrowers. Many of those borrowers still face risk of default on their student loans due to that emergency. Congress gave the Secretary of Education the authority under the HEROES Act to take steps to prevent that harm, and he is," an administration official said in a statement to ABC News.

Nebraska and five other GOP-led states challenging the plan argued in court filings that the White House can't have it both ways, pointing to President Joe Biden's remarks last year suggesting Americans could live with the virus going forward.

"The government has been undermining what the [Department of Education] said in the rationale memo. As to the COVID-19 justification, the president declared 'the pandemic...over' in September 2022. And as to the current economic conditions, the White House announced that 'household finances are stronger than pre-pandemic,'" the GOP states argued.

Copyright © 2023, ABC Audio. All rights reserved.

US births increased in 2021 for first time in seven years: CDC

Isabel Pavia/Getty Images

(NEW YORK) -- The number of births in the United States increased in 2021 for the first time in seven years, reversing trends that continued during the pandemic, according to new federal data.

A report published early Tuesday by the Centers for Disease Control and Prevention's National Center for Health Statistics showed there were 3,664,292 babies born in 2021, which is a 1% increase from 2020.

The figure marks the first increase seen since 2014. Between 2014 and 2019, births were declining by an average of 1% per year, and there was a decline of 4% from 2019 to 2020.

The report did not provide reasons for the increase, but Pew Research Center polls suggest women in the U.S. delayed having babies during the first year of the pandemic due to public health and economic uncertainty, so the rising number could be the result of a rebound.

The report also found the fertility rate for women in the U.S. rose by 1% from 2020 to 2021, sitting at 56.3 births per 1,000 women who are of reproductive age. It's also the first increase since 2014 after the rate declined by 4% from 2019 to 2020 and by 2% per year on average from 2014 to 2019.

Although the overall number of births rose from 2020 to 2021, the figure was still lower than the 7.74 million recorded in 2019, according to federal data.

When researchers looked at the number of births by race/ethnicity, disparities could be seen.

Among white and Hispanic women, the number of births rose 2% for each group between 2020 and 2021.

For Black and Asian women, the number of births declined by 2% from 2020 to 2021, and for American Indian/Alaskan Native women, the number of births declined 3%, the report showed.

According to the report, birth rates declined for women aged 15 to 24, rose for those aged 25 to 44 and were unchanged for the youngest age group, ages 10 to 15, and the oldest, ages 45 to 59.

The birth rate for those between ages 15 and 19 declined from 7% in 2020 down to 13.9 per 1,000 and the rate for those aged 20 to 24 fell by 3% to 63.3 per 1,000.

According to the report, both rates are record lows for their respective age groups.

By state, the number of births increased in 16 states from 2020 to 2021 and declined in one state, New Mexico. Of those 16 states, Connecticut, Massachusetts and New Hampshire had the highest increases of between 5% and 6%.

The report also looked at infant characteristics. Researchers found the premature birth rate rose 4% from 2020 to 2021, to 10.49%, which was the highest recorded figure since at least 2007.

The biggest increase was among early pre-term infants, or those born under 34 weeks gestation, at 4% from 2020 to 2021 compared to late pre-term infants, which are those born between 34 weeks and 37 weeks gestation.

Additionally, the number of babies with a low birth weight -- less than 5 pounds, 8 ounces -- rose 3% in 2021 to 8.52 from 2020.

It comes after the low birth weight declined from 2019 to 2020 following nearly 29 consecutive years of increases.

Copyright © 2023, ABC Audio. All rights reserved.



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