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sestovic/iStock(NEW YORK) -- The death of a loved one. A grave personal illness. Loss of income. These traumatic events rank among the most stressful experiences a person can endure, according to psychiatrists Thomas Holmes and Richard Rahe.

Amid the novel coronavirus pandemic, many American are facing these stressors.

The current pandemic is not just a medical tragedy. Even when the medical threat has disappeared, psychiatrists say people across the globe will battle psychological scars for years.

The documented connection between viral pandemics and psychological stress dates back more than 100 years ago, when Karl Menniger linked the 1918 Spanish flu pandemic with changes in psychiatric complications. The influenza virus most commonly affects the respiratory system, but the burden on neuropsychiatric diseases are under-recognized, he said.

A major study was conducted in 1920 in the United States to determine the impact of the influenza pandemic of 1918 on subsequent rates of suicide. Researchers concluded that the pandemic caused suicide to rise but a decline in alcohol consumption reduced national suicide rates.

Since then, many researchers have taken a closer look at the mental health impact during and after a pandemic. A study published in 1994 in the wake of the HIV/AIDS pandemic in The Journal of Crisis Intervention and Suicide Prevention suggested that those diagnosed with HIV were more likely to die by suicide and found that individuals with better support structures and less stress overall were less likely to die by suicide.

Since the Spanish flu pandemic of 1918, there has not been enough data gathered on the topic, given the absence of a pandemic of this magnitude and impact since. Experts say researchers will need to keep tabs on the mental health of the nation to see if the trends of the past hold true in the future.

President Trump recently announced that he is expecting the rates of suicide and drug addiction to increase due to the recent economic fallout. While no recent data can confirm or refute his claims, it is possible suicide rates will go up, but the future is uncertain.

"This is an unprecedented event for the vast majority of people. It is certainly reasonable to expect the risk of suicide increasing secondary to the economic and social fallout," Dr. Shailinder Singh who is a psychiatrist working in a psychiatric emergency room in a New York City hospital told ABC News.

However, he emphasized that "while some may argue this will directly correlate to an increased rate of death by suicide, there is simply not enough data, both current and historical, to suggest this will be the case," he added.

"Fear of losing one’s job is a major concern for those already suffering from mental illness," Singh added. With 6.6 million people applying for unemployment in the past month, there is major concern among mental health workers how this will impact depression and suicide rates.

According to the National Alliance of Mental Health, people are more likely to die of suicide if they also have experienced substance abuse, intoxication, medical illness, stress, have access to firearms, or suffered recent tragedy or loss. Drugs can create mental highs and lows that worsen suicidal thoughts. And more than 1 in 3 people who die from suicide are under the influence of alcohol at the time of death, NAMI reports.

Dr. Ken Duckworth, chief medical officer of NAMI told ABC News that rates of suicide aren't always closely tied with viral pandemics or high rates of unemployment.

"Economic instability and unemployment have been linked to increase in suicide," he said. "However in the past few years we have seen a rise in suicide despite economic prosperity."

Duckworth said that the pandemic seems to be fanning the flames, with NAMI seeing an increase in calls related to anxiety and depression over COVID-19.

"Most people are worried about having access to care, medications and whether supply of medications are running low," he said.

"People’s mental health needs, and call volumes to hotlines, may shift during the different stages of disaster, including in the recovery phase. It is very difficult to predict the duration or length of each stage, especially in a situation such as this, which carries a number of enduring stressors over time," John Draper, executive director, National Suicide Prevention Lifeline told ABC News.

Meanwhile, the pandemic has prompted many Americans to buy more firearms. The FBI reported a 73% increase in background check applications for gun purchases in March compared to the same month a year ago.

Experts say the wide availability of guns in America matters for suicide prevention because guns are more lethal than any other suicide method.

"We might see an increase in suicide in states where the ownership of guns are more acceptable such as Alabama, Ohio and Michigan," said Duckworth.

Meanwhile, one of the solutions for the pandemic -- social isolation -- could prove disastrous for mental health.

"Social distancing and isolation are triggers for people with mental health issues," said Singh.

"Humans being don’t do well with isolation," Duckworth added. However, he believes that technology will help keep connections alive as well as patient-doctor contact by telehealth visits.

“It will be an experiment. We would have to wait and see how technology will help lessen the impact of the pandemic," he said.

If you or a loved one is experiencing suicidal thoughts, The National Suicide Prevention Lifeline provides 24/7, free and confidential support. Call 1-800-273-8255 for help.

For resources regarding mental health treatment NAMI HelpLine is a free, nationwide peer-support service providing information, resource referrals, and support to people living with mental health conditions, their family members, and caregivers. Call 1-800-950-NAMI or text NAMI to 741741 If you are located in NY and need mental health support, call 844-863-9314. Yalda Safai MD, MPH is a psychiatry resident in NYC and contributor to ABC’s medical unit.

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WDnet/iStock(NEW YORK) -- People around the world are taking precautions to keep germs at bay amid the coronavirus pandemic, like wearing disposable gloves or masks in public, but the temporary solution could lead to another problem: litter.

PWD crews are working very hard during this difficult time, but we need @CityOfBoston residents to help. We continue to find discarded rubber gloves and masks on our sidewalks and streets.

Please be respectful of your neighbors and dispose of your trash properly. Don’t litter! pic.twitter.com/QlyDeCj32q

— Boston Public Works (@BostonPWD) April 1, 2020

News feeds online have filled up with photos of used personal protective equipment strewn about on sidewalks, streets and other public areas.

If using plastic gloves when out in public or when shopping it is essential to dispose of them properly.

Please dispose of these gloves in the nearest bin or bring them home with you and dispose of them in the general waste bin. Littering is never acceptable.

#COVID19 pic.twitter.com/LZvhNXQB8n

— Galway City Council (@GalwayCityCo) April 6, 2020

And beyond the obvious environmental impact, there's a larger concern that the once-worn items have touched contaminated surfaces and could pose a biohazard threat for those who eventually clean them up.

"Gloves protect you against contact with infectious materials. However, once contaminated, gloves can become a means for spreading infectious materials to yourself, other patients or environmental surfaces," the Centers for Disease Control and Prevention said in its PPE guidance.

As we continue to wear disposable gloves and masks to protect ourselves, please remember to properly dispose of used protective equipment in the trash bin. Improper disposal could lead to exposure to biohazards. For more information, visit https://t.co/fFTPtDpg4H pic.twitter.com/CTi6ckSLID

— OC Waste & Recycling (@ocwaste) April 7, 2020

City officials and health experts have called out the litter bugs in their respective areas and urged people to do better.

There’s no shortage of #PPE litter in Columbia Heights. Please do better, neighbors. ⁦@PoPvillepic.twitter.com/HvwiynhGEn

— Stacey (@sas509) March 31, 2020

The CDC has recommended gloves as a temporary barrier while cleaning and disinfecting, going in public for essentials, but also calls for proper disposal of them.

Stop the spread of #COVID19 while working from home. Clean & then disinfect surfaces such as tables, desks, phones, tablets, & keyboards. For electronic devices, follow manufacturer instructions or use alcohol-based sprays containing at least 70% alcohol. https://t.co/f6qgn7X7sp pic.twitter.com/IA74ghWbJK

— Dr. Robert R. Redfield (@CDCDirector) April 6, 2020

The World Health Organization has said people are better off washing and sanitizing their hands than using plastic gloves because bacteria and germs that stick to gloves could be spread to another person.

For anyone who does wear gloves in public, the safest practice is to remove them and dispose of them in a plastic-lined garbage bin that can be tied shut and be tossed out properly. If someone's in public and can't find a proper trash bin, they should take the PPE home and dispose of it in a sealed garbage can.

Be careful if you’re thinking about sanitizing your gloves. You may be reducing their effectiveness, depending on the chemicals used. There are lots of charts online that tell you what your specific type of gloves will be effective against.

— Dr. Jacquelyn Gill (@JacquelynGill) April 5, 2020

After discarding PPE, individuals are advised to wash their hands thoroughly for at least 20 seconds.

This is becoming a very frequent sight.

Disposable gloves discarded on footpaths, in shopping baskets and on top of bins.

Littering is always disgusting but now even more so it’s a total hazard.

Someone else has to pick these up, please dispose of them correctly pic.twitter.com/zYrhlIhbWW

— James Browne TD (@JamesBrowneTD) April 6, 2020

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Halfpoint/iStock(NEW YORK) -- The nation's death toll from the novel coronavirus surpassed 10,000 in the last 24 hours, but even that figure belied a grim truth: the real number of deaths is higher, but no one knows how much.

"There is no doubt the official death toll is an undercount," New York City Councilman Mark Levine, the health committee chairman, told ABC News.

The U.S. Centers for Disease Control and Prevention (CDC) is well aware that the figures -- which keep going up -- do not tell the full story.

"The current data on presumptive and lab-confirmed cases and deaths are underestimates," CDC spokesman Scott Pauley said Monday. "Right now, we believe that the number of deaths we have reported paints an informative picture of the scope fo the epidemic."

In New York City, the current epicenter of the U.S. coronavirus outbreak, the number of dead stood at 2,738 as of Monday evening, according to city statistics. And getting a full picture of the disease remains as important as it is elusive in these first weeks of the American COVID-19 crisis.

Experts say the only way to get a full understanding of the viral enemy is to know how many it has killed and from there, who succumbed, if they were old or young, if they were in perfect health or likely suffering from some underlying condition that made them vulnerable. How fast did they die? And did they die of the virus directly or of something like heart failure caused by their bodies fighting off coronavirus?

As to that last question, Pauley said, "It’s likely that COVID-19 related deaths may not be included on a death certificate or COVID-19 might be a factor related to an individual’s death but not the main cause."

That type of information is more than just cold statistics, experts say.

Deployed by public health agencies, that data could help cities across the country and throughout the world properly prepare for the surge in hospitalizations and deaths that could occur as the disease strikes elsewhere. As it turns out, doctors and scientists believe, it was an underestimation of potential COVID-19 fatalities in New York City that has wrought serious consequences.

Dr. Robert Glatter, assistant professor of emergency medicine and an attending emergency physician at Lenox Hill Hospital in Manhattan, explained the crisis hit before key record-keeping protocols could be established.

"There is still no formal uniform platform for reporting coronavirus-related deaths in the US,” Glatter said. “Along with a lack of test kits or even rapid antigen identification kits, the reality is that many states have been unable to categorize deaths as COVID vs. non-COVID.”

The issue goes back to January, when the average American seemed unbothered by the coronavirus. Glatter said that even in February most hospital systems and medical examiners did not yet have access to COVID-19 testing.

"We did the best we could with what we had,” said one emergency department doctor in Philadelphia, speaking on condition of anonymity. “We didn’t have much and that’s a fact. I’m confident we saw patients who died of COVID before we could test. We suspected it, but couldn't confirm it so the death certificates never contained COVID as the cause.”

The doctor said it is also possible that, before public health officials detected community spread within the US, many people who died of the coronavirus disease were diagnosed simply with influenza-like illnesses or pneumonia.

Now, with the public and private hospital networks in New York City overwhelmed to the point of drowning, there are no resources or time to test samples from the dead or resolve statistical problems, officials acknowledged. At the moment, hospitals in New York City are only testing for novel coronavirus among hospitalized patients.

With limited resources reserved for the severely ill, many are dying before getting tested or while test results are pending, city officials said, and there simply is no opportunity to conduct post-mortem testing -- something routinely done in normal times.

According to Levine, the number of deaths at home in New York City has grown 10-fold since the end of last week, even as hospitalizations for trauma and other emergencies have dropped to nearly nothing.

"Normally we have 20 to 25 deaths at home and now we are at 200 to 215,” Levine said, explaining that coronavirus would likely be the only way to explain such a spike.

Medical examiners offices across the country are now pitching in amid the crisis, shifting resources away from typical forensic pathology work to help with identifying the cause of death for the growing numbers of people dying at home -- because that work is so important.

“We are helping because we have experience in death and know about management and storage of dead bodies, but these cases are not the usual cases that come to us,” said Sally Aiken, chief medical examiner in Spokane, Wash., and president of the National Association of Medical Examiners.

In her own community, Aiken said anyone who has died at home and is suspected of having COVID-19 would be tested after death with a nasal swab, but she admitted that could change if testing were to become more limited.

"If there are enough deaths, there is a point it will overwhelm the jurisdiction, no matter the size and everyone will have to make practical decisions that are not pretty to think about,” Aiken said. “We have to understand that at some point we may not be able to test everyone or look at every body.”

That is what has happened in New York City, the nation’s largest city and the site of the worst outbreak of coronavirus in North America.

"There is no swabbing of deceased individuals anymore and unless the medical examiner has knowledge of a confirmed coronavirus test, then they aren’t being marked down as having coronavirus,” said Levine, whose committee has oversight for the Office of the Chief Medical Examiner.

The CDC last month issued guidance on postmortem specimen collection of suspected COVID-19 deceased patients to ensure consistency across state response, but Aiken said she doubts there would be a “uniform response to the death of COVID-19” because of the lack of a “uniform system” across medical examiner offices – something that could also lead to coronavirus deaths being omitted from the stats.

And, she said, the many patients with underlying conditions who are dying before they can even get to a hospital are also likely to be counted inaccurately.

"You have a lot of [emergency medical services] workers who are pronouncing people dead from things like cardiac issues,” Levine said. “Are those coronavirus victims? Probably are, but they are not being categorized as such in death."

To try and get a more accurate picture of the crisis, the CDC last week issued updated guidance for certifying deaths due to COVID-19 – protocols similar to those in place for pneumonia and influenza. According to the new directions, if a patient has died from pneumonia, for example, but was also tested positive for COVID-19, someone is required to specify whether COVID-19 played a role in the death and whether it was actually the underlying, primary cause of death.

"Ideally, testing for COVID-19 should be conducted but it is acceptable to report COVID-19 on a death certificate without this confirmation if the circumstances are coming within a reasonable degree of certainty,” according to the new CDC protocols, though coronavirus still cannot be listed as the primary cause of death without a confirmed lab diagnosis.

Cécile Viboud, a staff scientist at the National Institutes of Health (NIH) who specializes in the mortality associated with infectious diseases, said it will likely take years to know the actual death toll of the contagion that has nearly paralyzed much of the nation.

In previous research on the 2009 H1N1 pandemic, Viboud said she concluded that only 50% of the deaths attributed to the disease were correctly labeled.

When it comes to COVID-19, she said it's hard to predict how far off the U.S. will be. Experts said there are other factors that make the grim accounting even more challenging. For one thing, the vast majority of those who die from COVID-19 are older or have other ailments, making it harder to pinpoint the precise cause of death. Plus, experts will have to wait years before they can accurately quantify the number of people who may have died indirectly from the pandemic.

“Everything we're doing to flatten the curve has major societal and financial impacts that can increase death rates,” explained Samuel Scarpino, who leads Northeastern University's Emergent Epidemics Lab. For instance, he said, there can be “indirect mortalities because a hospital, for example, doesn’t have a ventilator available for a non-COVID-19 patient.”

Undercounting the death toll impedes policy makers’ ability to understand severity of the disease, effectively allocate resources, or make decisions regarding school and business closures, experts and public health officials agree.

The emotional toll is no less important. Funeral homes are overwhelmed by the number of deceased bodies and funeral directors have said they are worried for the safety and health of their own employees asked to bury and handle bodies who may have been infected with COVID-19.

Family and friends are also left to wonder whether have been exposed to the virus and are contributing to its spread, without realizing it.

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Moyo Studio/iStock(NEW YORK) -- After a trip to the grocery store these days, does re-entering your home leave you wondering what level of hazmat decontamination is necessary?

We asked Dr. Angela Rasmussen of Columbia University -- a researcher who studies viruses, including the one that causes COVID-19 -- how she disinfects when returning home from the store.

What She Does

1. Use hand sanitizer in the car

Rasmussen says the process starts when she gets into her car in the parking lot.

"I sit down I get my hand sanitizer out," she said, noting she spends about 20 seconds rubbing it around her palms and fingers. "I put some on the steering wheel, too," she added.

2. Avoid touching your face

Rasmussen says she’s really careful not to touch her face until she gets home.
 
3. Immediately wash hands at home

Once home, Rasmussen said she takes off her jacket, places her bags inside the door and immediately washes her hands.

She also takes off her shoes but adds, "that’s not corona related, it’s because outside is gross and I like to be barefoot in my house."
 
4. Put groceries away

Rasmussen said she puts her groceries away -- and then washes her hands again.

5. Clean your phone

If she used her phone while on her journey, Rasmussen said she wipes it down with a disinfectant wipe or alcohol.

"Phones are a potentially higher risk for fomite transmission, transmission from surfaces because they are in close proximity to both your hands and your nose and mouth," she said.

After that, she said she feels fine going about her normal activities at home.

What She Doesn’t Do

Wash bags


Rasmussen said purses, jackets and fabric don’t usually need any special attention, adding "there’s very little evidence that virus transmits from clothing."

But she adds that if you think you or your jacket or bag has been in "direct contact with someone coughing or sneezing," a wash is a good idea.

Change or shower

She also doesn’t change her clothing or shower/wash her hair.

"The likelihood of having a significant amount of virus on your hair that could get on your face or in your mouth is very low," Rasmussen said.

But she adds, "If people feel more comfortable changing clothes or showering, they are welcome to do that, but the risk -- unless you had direct contact with someone pretty sick -- is pretty low."

Wipe door handles on every trip

She doesn’t wipe her door handles after every trip out, but she does clean them sporadically.

"Those are high-touch surfaces, so when we’re receiving deliveries, we have more opportunity from other people outside our home to be in contact with them," she said.

Dr. Rasmussen reminds people that this disease is primarily spread through respiratory droplets encountered through close, person-to-person contact, and she says germs on surfaces degrade and become less effective at infecting people over time.

"Viruses can’t reproduce without a host, so any virus on a surface is going to immediately begin to be less infectious," she said.

And while a study published in The New England Journal of Medicine says the disease can exist on surfaces like cardboard for 24 hours, and plastic and metal for 72 hours, the longer it’s outside the body, the less potent it becomes.

"Over that time, the amount of infectious virus decreases," she said.

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Peter Fitzpatrick/U.S. Navy(NEW YORK) -- The U.S. military is 3D-printing face shields, designing reusable plastic N95 masks and sewing surgical masks to increase the supply of critical medical equipment as hospitals across the U.S. work to combat the coronavirus pandemic.

Nine Navy and Marine Corps commands began their 3D-printing efforts on March 28 after the Federal Emergency Management Agency requested the initial production of 220 medical face shields, the Navy said in a news release.

Days later, the assistant secretary of the Navy for research, development and acquisition authorized all of its commands to support FEMA requests, saying that the country is in a national emergency so they "must engage accordingly."

The U.S. military is uniquely poised to assist in the production of personal protective equipment because of its expertise in additive manufacturing, or 3D printing.

The Marine Corps' Advanced Manufacturing Operations Cell (AMOC) was the first to receive FEMA's request for 220 face shields before alerting other Department of the Navy manufacturers.

"Every (additive manufacturing) producer I reached out to stepped up," said Marine Capt. Matthew Audette, an advanced manufacturing project officer with AMOC. "It speaks volumes of our additive manufacturing community that every group was confident that they could produce the entire request on their own. We broke it up to distribute the load."

According to the Navy, the department is now working with the Pentagon and industry "to determine the volume and scope of (additive manufacturing) requests, the capacity to manufacture and distribute production across sites and ensure quality standards."

And those efforts are extending across the entire U.S. military.

Some Air Force instructors have started 3D printing, not only face shields, but reusable plastic N95 face masks, the service said.

Instructors with the 312th Training Squadron's Special Instruments Training course at Goodfellow Air Force Base in Texas were inspired by similar efforts they saw on social media.

“We saw other people 3D printing medical supplies, and we thought we should try printing things like face masks and face shields,” said Master Sgt. Manuel Campo, special instruments training flight chief.

The instructors found a free model online for a 3D-printable, high-efficiency filtration mask designed by a neurosurgeon in Billings, Montana, who worked with a dental company to create the masks.

The group plans to present their prototypes to a medical group to see if they can meet hospitals' needs during the pandemic.

At Joint Base Lewis-McChord in Washington, 1st Special Forces Group soldiers who normally use sewing machines to repair parachutes are now producing surgical masks, according to the Defense Department.

The Group Support Battalion is creating the masks, along with prototypes for respirator masks and 3D face shields, for its local Madigan Army Medical Center and regional partners.

The Aerial Delivery Platoon is already able to produce 200 masks in a day with expectations to eventually produce 1,000 to 1,500 masks per week, said Army Lt. Col. Christopher S. Jones, the battalion's commander.

"I believe this is a phenomenal effort to help our health care professionals and fellow Americans," Jones said. "We're collaborating with (Army Special Operations Forces) and conventional forces across the Army to make a difference. The effort in and of itself is a worthwhile exercise in how to innovate to provide solutions, especially as the U.S. military has the best capability in the world."

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Chainarong Prasertthai/iStock(NEW YORK) -- The national hotline providing emergency help to people suffering from emotional distress has received nearly nine times more calls than it did this time last year, with tens of thousands of Americans reaching out for assistance amid the coronavirus crisis, according to U.S. officials.

Federal officials on the front lines of the U.S. government’s pandemic response have privately warned members of the White House and Department of Homeland Security that many more Americans will find themselves in “dire straits” over the coming weeks, and that U.S. agencies have yet to properly prepare for the unfolding “mental health crisis.”

“I am very concerned,” said one U.S. official.

Though the Trump administration has recently approved hundreds of millions of dollars in federal funding to boost mental health services, the official suggested even that additional money may not be enough to support the crisis counseling that will be needed.

Last month the “Disaster Distress Helpline” at the Substance Abuse and Mental Health Services Administration (SAMHSA) saw an 891% increase in call volume compared with March 2019, according to a spokesman for the agency, which is part of the Department of Health and Human Services.

In fact, this March -- ending a little more than a week ago -- saw 338% more calls to the helpline than in the month before, when the deadly virus began to take hold inside the U.S. homeland, and government officials began taking more extreme measures to stop its spread.

The agency's spokesman would not offer specific total figures, but the U.S. official said that last month the agency received more than 22,000 calls and text messages seeking help.

Nevertheless, over the past several weeks, mental health has only been discussed sporadically at the daily televised briefings from the White House.

Last week, on March 29, President Donald Trump suggested it is "common sense" to expect a “massive” jump in mental health issues.

“You’re going to have massive depression,” he said. “You’re going to have depression in the economy also. … [Expect] massive drug use, massive depression, mental depression, massive numbers of suicide.”

Two days earlier, Trump signed the $2 trillion emergency relief package known as the “CARES Act,” which set aside $425 million for SAMHSA “to address mental health and substance use disorders as a result of the coronavirus pandemic." Another $100 million is marked to supplement the agency's federal grant programs, according to Health and Human Services.

The bill also included $250 million for “Certified Community Behavioral Health Clinics” to increase access to mental health care services, and another $50 million for suicide prevention efforts, according to HHS.

A White House official pointed to additional funding aimed at supporting mental health among military veterans and Native Americans.

According to the SAMHSA spokesperson, his agency has been working “very closely” with other federal agencies to address growing mental health problems and to relax federal restrictions so that people can more easily access the help they need.

But the U.S. official described federal efforts so far as still insufficient to address what the official believes will be happening on the ground in the weeks ahead, especially as the need for crisis counseling expands.

“Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children,” SAMHSA noted on its website devoted to the coronavirus.

Many are suffering from fear and anxiety about stay-at-home orders, “social distancing,” supply shortages and wide-scale unemployment. Homeland security officials have privately worried that already-unstable Americans could be propelled to violence by stress associated with the pandemic.

There are 57.8 million Americans currently living with mental or substance use disorders, according to SAMHSA.

The Disaster Distress Helpline is operational 24 hours a day, every day of the year. Its staffers “provide counseling and support before, during, and after disasters, and refer people to local disaster-related resources for follow-up care and support,” according to the agency's website.

Even before the coronavirus crisis hit, agencies like the SAMHSA received limited federal funding for their efforts. And while the mental health agency's budget has actually increased in recent years under the Trump administration, which has seen some of the nation’s worst mass shootings ever, the administration is seeking a slight cut in that funding for 2021, with a total request of $5.7 billion. Other agencies saw cuts as well.

A White House spokesman did not respond to an email seeking on-the-record comment for this article. And a message on Monday seeking comment from the Office of the Assistant Secretary for Preparedness and Response at HHS was not immediately returned.

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Rike_/iStock(NEW YORK) -- Following the Centers for Disease Control and Prevention's new recommendation that Americans wear cloth face masks in public, especially in areas with significant COVID-19 spread, many are asking which materials offer the best protection against the virus.

Americans can use "cloth face coverings fashioned from household items or made at home from common materials at low cost," the CDC website says.

Dr. William Schaffner, medical director for the National Foundation for Infectious Diseases, said it's easy to get "hung up on the materials."

"The concept is to get something in front of your face, even if you’re tying a bandana in front of your nose and mouth," he told ABC News.

Masks work in two ways, Schaffner explained.

They prevent particles from exiting the mask wearer's nose and mouth but masks also prevent outside particles from getting inside the wearer's nose and mouth. Still, the data to support wearing cloth masks to keep particles out, and thus stop the mask wearer from getting sick, is thin, he said.

In other words, wearing a cloth mask probably won't protect you. But that doesn't mean you should ignore the CDC's recommendation to wear one.

"The utility of a mask to inhibit what's going out is pretty good," Schaffner said.

There's mounting evidence that a significant number of individuals who contract the virus may spread it before developing symptoms, or may be asymptomatic.

"This means that the virus can spread between people interacting in close proximity -- for example, speaking, coughing, or sneezing -- even if those people are not exhibiting symptoms," the CDC notes. "In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain."

While the personal protective benefit of wearing a mask may be low, the benefit to society at large is real.

"You can protect those around you by wearing a mask and they will protect you," Schaffner said. "If we all do that, it makes it more difficult for the virus to move from one person to another."

The new recommendations do not mean that Americans can relax other public health measures, such as social distancing. Instead, they should wear facial protection while continuing to keep at least six feet between themselves and others, while also remaining at home whenever possible.

Americans also "shouldn’t go out and buy masks that otherwise should be used in health care settings," Schaffner noted. While N95 masks are more effective at keeping particles out and better protect the mask wearer, they are in short supply and should be reserved for health care workers and first responders, according to the CDC.

For more information on how to make a cloth mask, see the CDC's mask-making tutorial.

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iStock(NEW YORK) -- As the novel coronavirus continues to spread and devastate communities, the United States is still struggling to do enough testing to understand the true scale of the epidemic.

Now, researchers around the country are looking for new tools to help track how the virus is spreading. Testing your sewage may be one way.

The need to find new ways to measure this epidemic has become even more urgent in recent weeks. According to CDC Director Dr. Robert Redfield, about 25% of Americans may be asymptomatic carriers, meaning they are infected but will likely never get tested because they don’t have symptoms.

The current coronavirus test swabs your nose and mouth, but scientists have also detected the virus in the stool of infected people. The virus then gets into sewage water through infected stool, giving scientists an indirect way to tell if the virus is present.

This is not the first time this type of technology has been used to track diseases in communities. In 2013, a polio outbreak was detected in Israel through sewage water testing, prompting a polio vaccination campaign to help stop the outbreak from becoming an epidemic.

Now, at least two independent research teams in the United States are developing technology to measure how much COVID-19 is in sewage water to help track virus spread.

One of those teams is led by Dr. Ian Pepper, director of the University of Arizona Water and Energy Sustainable Technology (WEST) Center. Dr. Pepper said the technology involves taking a sample of sewage water back to the lab, then using a molecular test called polymerase chain reaction, or PCR, to test the water for COVID-19. If the water tests positive, more tests are run, including attempting to grow the virus to see if it is still active. PCR is also used for the current COVID-19 nasal swab test.

Ultimately, this technology detects if the virus DNA is in the sewage water, and how much. Dr. Pepper explained even though virus DNA can only survive in water for a limited time, even after it is inactive the DNA is still in the water.

Newsha Ghaeli is president and co-founder of BioBot, a startup spun out of the Massachusetts Institute of Technology (MIT) in Cambridge, Mass. Her team also specializes in using wastewater for tracking diseases.

According to Ghaeli, public health is becoming more data-driven and one day wastewater data may drive policy decisions, such as where resources should be sent in a disease outbreak.

Can this technology tell how many people are infected with coronavirus in a community? Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital, noted it may not be very reliable for giving exact numbers, but this technique is still a helpful way to show if the virus has reached a community or not.

Dr. Pepper noted the technology is very useful when a disease first starts spreading, but even after a disease is widespread it still has important uses.

“It can tell us if the amount of virus [in a community] is increasing, decreasing or staying the same," Dr. Pepper said. "This may be very useful if hopefully the virus goes away this summer, for monitoring in the fall in case it reemerges.”

Dr. Eric Alm, professor at the MIT Center for Microbiome Informatics and Therapeutics, and scientific director at BioBot, noted that this kind of technology may be key in figuring out when we will flatten the curve. In the future, it may help us stop epidemics from happening at all.

“Wastewater data may become more reliable than individual testing, especially if hospitals become overwhelmed," Dr. Alm said. "We hope to use this kind of data to stop outbreaks before they reach epidemic levels so we will never find ourselves again in a situation like we are in today.”

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lisegagne/iStock(LOS ANGELES) -- A California woman spent 12 hours straight sewing masks for those on the front lines of the coronavirus pandemic -- and she's not stopping there.

Hilary Cohen has always been at home at her sewing machine. So amid the coronavirus pandemic with mask shortages dominating the headlines, the Los Angeles resident got to work, sewing 100 masks and organizing a virtual 12-hour sew-a-thon to bring sewers together to make as many face coverings as possible.

“In such a dark time, it is so uplifting to see the community come together,” Cohen told GMA. “Sewing by nature is very lonely. Now, everything is lonely -- it was really nice to feel connected to people and a community again.”

Cohen's March 30 sew-a-thon was part of the Million Mask Challenge, an initiative launched by Providence Health & Services -- a Washington state based health care system -- to produce protective gear for health care workers.

Cohen has donated 189 masks to Cedars-Sinai Hospital in Beverly Hills (100 from her and 89 more from another donor), which will be going to janitors, security guards, and hospital workers who don’t work directly with patients, according to Monica Monroy, a donations coordinator at the hospital.

Monroy, who learned about Cohen’s sew-a-thon after she received her inquiry online, said she was stunned by the idea that a stranger would be willing to donate to the hospital.

“I remember the day I called her,” Monroy told GMA. She said that she was gonna have a mask marathon and it was so cute. And she said she’s rallying people to make them with her and I remember telling her that we are so grateful to her -- they’re even more meaningful.”

Over the weekend, the Centers for Disease Control and Prevention advised the use of cloth face coverings -- like the ones Cohen has been making -- even for people who aren’t exhibiting symptoms.

“The virus can spread between people interacting in close proximity -- for example, speaking, coughing, or sneezing -- even if those people are not exhibiting symptoms,” according to a statement on the CDC’s website.

And while face masks bought from stores are impossible to find these days, a face covering "can include anything that covers your nose and mouth, including dust masks, scarves and bandanas" to "prevent you from spreading COVID-19 to other people," according to the NYC Health website.

These face coverings are not medical-grade masks such as N95 masks, which officials stressed must be reserved for health care workers.

The handmade fabric masks sewn by Cohen fall into the face covering category, and will be distributed to hospital staff at Cedars-Sinai who aren’t in direct contact with COVID patients.

And now that it’s recommended that everyone wear masks, she said that she won’t say no to anyone who asks for a mask.

“I get orders and requests daily from people I have never met and all over the U.S. and the world,” she said. “I will sew for whoever needs one. So until there is [not] a need, expect to find me at my sewing machine.”

Cohen's sewing spree began last month when she first noticed that employees at her local Ralph's grocery store were not wearing anything to cover their face.

“I’m just so aware of [workers] every time I go to the grocery store,” Cohen told GMA. “I feel so bad for them and everyone needs them to keep working.”

While mandates across the country have closed many businesses, grocery stores remain open and workers are still required to work, often at the risk of getting sick.

“When you apply to be a bagger at a grocery store, the stress level is not a high stress level job,” she explained to GMA. “Those people are now in this crazy scenario and it’s overwhelming for somebody who agreed to be a grocery store clerk.”

So Cohen, who is an assistant director for the show NCIS: Los Angeles, sat down that evening at her sewing machine that she’s had since she was 12. She pulled some scraps of fabric from a bin of material that she’s collected over the years, and got to work on a mask pattern provided by Jo-ann craft store.

Just from her craft bin alone, she was able to sew 106 masks, and she donated them all to local grocery store workers.

She posted photos of the masks on her Instagram, hoping to inspire others to sew, and she received an overwhelming response from people who cheered her on and wanted to help too.

On March 30, Cohen held her 12-hour sew-a-thon, which began at 7 a.m. She shared the event on Facebook and went live there and on Instagram, where she walked through the mask-sewing process.

In total, 50 sewers from more than 30 states and four countries participated, and at the end of the day they shared photos of the masks they were able to produce.

For those that want to help make masks, Cohen encourages people to reach out to hospitals or people in their community that would like masks. She also is welcoming toward others who want to reach out to her personally on Facebook so she can help direct them to where they can donate.

Cohen said she also is planning for a larger 12-hour sew-a-thon on Saturday, April 11, and she is trying to get 500 sewers from across the country to participate. More information can be found on her website, Call to Crafting.

“There are thousands all over the U.S. and world sewing at a time where we are being forced to distance ourselves,” Cohen said. “My hope is to bring the community together -- offer them a space to share ideas and thoughts, provide them with a virtual sewing-mate and some entertainment.”

For more information on how to create masks, click here.


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HRAUN/iStock(NEW YORK) -- Already told to boost patient capacity by as much as 100%, many hospitals in New York state, the nation's top hot zone for the coronavirus, reached overcapacity on Sunday, Gov. Andrew Cuomo said.

In Michigan, Gov. Gretchen Whitmer said the state's hospitals, specifically in the Detroit area, are already at capacity and medical staffs are on the brink of being overwhelmed.

Louisiana Gov. John Bel Edwards warned on Sunday that his state could run out of working ventilators by Thursday and ICU beds by next weekend.

As the coronavirus crisis sweeps across the nation, hospitals administrators say their medical personnel are struggling to keep up with a flood of infected patients -- and the apex of the pandemic could still be days and possibly weeks away.

“I guarantee the people of the state, that as long as I'm governor of this state, we won't lose a life if we can prevent it,” Cuomo vowed Sunday during his daily coronavirus press briefing. “We are not going to lose a life because we didn't share resources among ourselves.”

No medical professionals are feeling the crunch more than those in New York City, where the number of hospitalized confirmed coronavirus patients has soared past 13,000 and the number of deaths has surpassed 3,000.

As of Saturday afternoon, 30 New York City hospitals were at or near ICU bed capacity, according to information included in a FEMA report reviewed by ABC News. Seven of the hospitals were at or near total capacity, according to the report. All New York City hospitals are expected to be at or near total capacity during the coming week, the report shows.

Officials cautioned that the numbers of hospitalized patients fluctuate hour-to-hour as patients are admitted and discharged and, in some cases, transferred to other hospitals. Some downstate patients were transferred to Albany-area hospitals, Cuomo announced this weekend.

“The operational challenge for the health care system is impossible. The system is overcapacity, all across the board. It is just overcapacity,” Cuomo said.

On Thursday, President Donald Trump approved a request from Cuomo to allow coronavirus patients to be treated at a temporary 2,500-bed hospital created at the Jacob Javits Convention Center in New York City. The temporary hospital, built in less than four days by the Army Corps of Engineers, was initially intended to handle the overflow of non-coronavirus patients.

The Army Corps of Engineers is also building at least three other pop-up hospitals in New York City to help meet the staggering demand, and the U.S. Navy's 1,000-bed hospital ship, the USNS Comfort, has been docked in New York City to treat non-coronavirus patients.

Cuomo said the total daily number of new hospitalizations in New York state went down between Saturday and Sunday to 574 from a high just five days earlier of 1,412. He said the downward trend was "partially a function of more people being discharged." He said 75% of the people who have gone into the hospital system have recovered and have been discharged.

"We’re looking at this seriously now because by the data we could be very near the apex or the apex could be a plateau and we could be beyond that plateau right now," Cuomo said. "We won't know until we see the next few days, does it go up or does go down, that’s what the statisticians will tell you today."

As New York flirts with its apex, other areas are getting worse.

Michigan's Gov. Whitmer said on Sunday that in Detroit coronavirus cases continue growing exponentially. The number of confirmed coronavirus cases in Detroit grew by about 400 between Friday and Saturday to nearly 4,000, according to the city's Department of Public Health. At least 129 people have died there from the disease.

"We know that we’ve got hospitals that are already at capacity," Whitmer said on Sunday in an interview on Fox News.

"This is something that is aggressively growing in all age groups all across our most populous part of the state, which is Southeast Michigan," Whitmer said.

Dr. Nick Gilpin, medical director for infection prevention at Beaumont Health in St. Clair Shores, Michigan, told ABC News that the number of cases have come so "fast and heavy" that he's "not sure any level of preparedness would have been enough" to respond to the pandemic.

"I think it's fair to say that Detroit is getting crushed right now. … We were watching China and trying to anticipate how this would play out," Gilpin said.

Gov. Edwards of Louisiana warned on Sunday that his state could run out of working ventilators by Thursday and ICU beds by next weekend.

As of Sunday, Louisiana had more than 13,000 confirmed coronavirus cases with at least 4,000 of those in New Orleans, according to the state's Department of Health. At least 477 people in Louisiana have died from the virus, officials said.

Edwards told CNN that his recent projections are better than last week's model that showed the ventilators would be used up by Tuesday, because the rate of COVID-19 infections appeared to be declining as more people practice social distancing.

"We hope we can continue a downward trend on the rate of transmission of new cases. That buys us a little more time," Edwards said.

In neighboring Texas, the problem isn't near as bad. As of Sunday, Texas had 6,812 confirmed coronavirus cases, with nearly 1,300 of those in Houston and more than 1,000 in Dallas. Texas has recorded 127 deaths linked to the virus.

Dallas' 15 hospitals reported to Dallas Mayor Eric Johnson on Thursday that about 50% of the 4,763 hospital beds in the city were available.

Texas Gov. Greg Abbott said at a news conference on Friday that there was an ample amount of hospital beds available across the state. Out of a total of 47,585 hospital beds across Texas, about 41%, or 19,696 were available, including 2,107 ICU beds, Abbott said.

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Cecilie_Arcurs/iStock(NEW YORK) -- Jenn Hubbert was working from home on March 17 when her husband called out to her from across the house.

“He was watching TV when he realized the breaking news was about my mother’s nursing facility,” said Hubbert, a real estate agent in Florida. “The first death from coronavirus had been reported, and I didn't even know there was a case there. I was in disbelief.”

The Hubberts are part of a growing segment of the country suffering through the anxiety of a global pandemic with a loved one in a nursing home -- an anxiety-ridden experience as their elderly relatives remain locked down in facilities that have proven to be highly vulnerable to viral spread.

Since the coronavirus engulfed a senior living center in Kirkland, Washington, on Feb. 29, at least 400 nursing facilities in more than 25 states have seen at least one resident contract COVID-19, according to the Centers for Disease Control and Prevention. Across the country, nursing homes are seeing deadly outbreaks almost every day. More than 100 residents and staff were infected and 18 died at a home in Maryland, and more than 100 others were infected and five died at one in Tennessee; and 133 tested positive and 17 died at a facility in Virginia, according to figures released by the states last week.

In an effort to shield the facilities, nursing homes across the country have enacted tight cordons, banning visitors and isolating residents. Already under immense pressure as they attempt to combat the virus, nursing home staff are also trying to field urgent questions from concerned family members about conditions.

The combination of the well-intentioned measures and lack of information has been hard on some families, who told ABC News the limited interactions with their loved ones have added to their emotional strain and in some cases left them in the dark and unable to check on their relatives' well-being.

In Louisiana, Tunney Barrett says he learned of an outbreak at his mother’s nursing home through news reports. But when he called to learn more, Barrett said the facility initially would not say anything and at first denied the positive case. He was unable to get information directly from his mother, he said, because she has Parkinson’s disease and dementia.

“They don’t understand what families are going through,” Barrett said. “We are being kept in the dark about what’s going on.”

Barrett said he has considered trying to remove his mother from the nursing facility, but he said he worries he cannot provide her with the around-the-clock monitoring she needs.

For Caroline Langdon, whose 85-year-old mother has advanced Alzheimer's disease and is a resident in the memory care unit at St. James Place in Louisiana, the hardest part is not being able to continue her routine of seeing her mom every week.

"It's kind of twofold though because with my mom, she has no concept for time anymore, so where some people could still call their loved one and have them pick up the phone or ... they started doing a FaceTime thing to assist the residents, my mom wouldn't know what to do with that,” she said.

Cathy West is in a similar situation in Illinois. Her 87-year-old mother lives at Alden Courts of Shorewood facility southwest of Chicago, where a visitation ban has been in place for over a month. Last week, Cathy West said the facility informed her family of its first positive case for COVID-19.

West said her mother struggles with short term memory and does not understand why she can’t see her children. She said it was “extremely difficult” to walk away from her mother each time a visit ends, as her mom asks why she hasn’t come inside.

“My mom is heartbroken and she doesn’t understand why,” West said. “She can’t understand what’s happening.”

Officials with nursing homes interviewed by ABC News said they are focused on a challenging set of priorities, chief among them protecting residents and staff from the potentially deadly virus. At the same time, they are trying to keep their facilities supplied with protective equipment, plan for how to respond if residents fall ill, and maintain a sense of comfort and normalcy for residents.

Melanie Burgess, a nurse at an assisted living facility in New Jersey, said the burdens can make it difficult to keep pace with the inquiries from relatives.

“Right now, nursing homes are struggling.” Burgess said. “And we are doing everything we can, so families need to trust us.”

Dr. Mark Gloth, the medical director for one of the nation’s largest senior living chains, HRC Manorcare, said the facilities understand the stress the outbreak has placed on those family members who have relatives in nursing care. He told ABC News he wants relatives to know that “throughout our system, people taking care of your loved ones are deeply invested in taking the best care possible.”

“We want to be an extension of you,” he said. “Please know we are doing everything we can to be helpful, caring, and to respond to the needs that you have.”

For those whose older relatives have already tested positive for COVID-19, it can be an enormous challenge.

Maria Castro, a lawyer in Miami, said she is especially concerned for both of her in-laws. They live at Atria Willow Wood, a senior living facility that houses 219 residents in Florida. As of Saturday, seven residents have died and 20 have tested positive for COVID-19.

Castro says that her father-in-law, Ángel Rodriguez, 87, was placed in the same room as his wife, Ivonne Camacho, 82, after he tested positive for the coronavirus.

“It was only a matter of days until my mother in-law tested positive too,” Castro said. “And the facility doesn’t update us on how they are doing which makes this situation so much worse.”

In a statement to ABC News, Atria Willow Wood maintained that they were keeping the families of their residents informed regularly. The facility declined to address Rodriguez's case.

“We remain in daily communication with residents and families as well as the different state and local agencies, including the Department of Health office in Broward County, and others, and will continue to work with them as we monitor and respond to this situation,” the statement said.

The nursing facility ultimately decided to move Rodriguez to a hospital when his condition worsened. Castro said the family is gripped with worry.

“We brought them [to Florida] from Puerto Rico in the hope of giving them a better quality of life. This was not supposed to happen.” Castro said. “All I want is to see them again."

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jarun011/iStock(NEW YORK) -- Longtime ABC News Correspondent Bob Woodruff’s 28 year-old son, Mack, has been diagnosed with COVID-19. He believes he came down with the virus while traveling from Europe to Sydney, Australia, while on a film project.

Bob Woodruff spoke to his son about what he saw countries doing as the virus continued to spread across borders.

"Traveling from France to Switzerland was not an issue. I think if you are traveling on the other side of the border, Italy's border with Switzerland, it was a huge issue," Mack said.

Mack says he may have caught the virus while at a dinner gathering with a large group of people while restaurants and bars were packed to enjoy their last day open for what they would anticipate to be the next four to five months.

During this time, however, Europe was peaking -- although people didn’t seem to be too concerned, according to Mack. Parties and gatherings were in full swing as French President Emmanuel Macron appeared on television to announce all non-essential businesses would be shut down.

“So when the guy sitting next to me ordered a cheeseburger, the waiter came and said, this is probably going to be the last cheeseburger served in this town for six months," Mack shared.

The following day, Mack got on his flight to Sydney.

"My chances of being infected in those airports, Geneva and Dubai and Sydney, the only other places I can think that it could have happened," Mack said.

When the plane landed in Sydney, an announcement came over the speaker as they taxied to the gate explaining that the health organization would board the plane and hand out flyers.

"I believe it was a guy and a girl came onto the flight dressed pretty much in a full hazmat suit. They had face masks, and they handed out flyers about what you should be doing during the first two weeks that you are back in Australia. Self-quarantine is a mandatory 14-day quarantine. You can't go outside. If you do, you have to wear a mask, but only for mandatory activities," Mack explains.

Assuming his headaches were caused by jetlag, Mack overlooked the novel coronavirus symptom. Not until he had a loss of smell and taste did he come to the conclusion that he may be infected with COVID-19.

"I've lost my sense of taste before, but never to this extent. Still to this day, I could bite into a chocolate bar and bite into a lemon and I don't decipher any difference in taste," Mack says.

Staying in good spirits though, he jokes about his father’s food saying, “now I can finally eat [his] cooking."

The road to recovery is tough but a big relief when it’s possible. Those recovering look forward to the simple pleasures in life -- for some it's the sunshine touching their face again or, in Mack's case, enjoying cookies.

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Courtesy Eda Akyar(NEW YORK) -- In a time of so much uncertainty, no one has all the answers, but COVID-19 hotlines across the country have assembled to try to answer some of the thousands of questions Americans are pondering right now.

While hotlines cannot provide clinical advice as a doctor can, the staff can still answer questions regarding novel coronavirus testing, symptoms and prevention.

Some, but not all, state health departments have set up their own hotlines, while a number of hospitals are also fielding calls from local communities. A federal hotline has yet to be created and it is unclear if one is in the works.

Thousands of calls come in to these hotlines every day. Florida’s emergency operations center told ABC News their hotline received over 130,000 calls from March 18 to March 29.

Michigan, a state with over 14,000 positive cases, has also set up a remote hotline call center to keep up with the amount of daily calls. Michigan’s hotline told ABC News they answered almost 97,000 calls from March 24 to April 2.

Hotlines create greater "equity of information," Chris Jackson, the state assistant administrator with the Michigan Department of Health and Human Services (DHHS), told ABC News. "Not everybody has access to the internet. Whether they're low income or seniors who might not be comfortable with the internet, or even here in Michigan, [with] rural populations that may not have internet but [they do] have access to the phone."

"I have been so overwhelmed by the dedication of all of our state employees who have stepped forward to staff that hotline seven days a week," Sarah Esty, Michigan DHHS senior deputy for policy and planning, told ABC News. "Many of them have kids at home, have family members they are caring for, have regular day jobs with DHHS that they are juggling alongside stepping up to be trained and answer questions coming in from residents across the state."

In Chicago, a group of medical students from Loyola University took it upon themselves to help staff the Loyola Medical Center's COVID-19 hotline. While not fully licensed physicians, they had medical knowledge and no way to use it due to following the CDC's social distancing guidelines. So they began volunteering at Loyola’s call center and answering questions based on constantly changing CDC information and Loyola medical center’s instructions.

"We had young and old people crying just out of fear on the phone," said Eda Akyar, a third-year medical student at Stritch School of Medicine and one of the hotline’s student leaders. "Having someone to speak to at Loyola Medical Center really helped calm some people down and put into perspective the things you need to do to keep yourself healthy in this very stressful time."

One Loyola medical student volunteering on the hotline, Richie Green, a fourth year Stritch student, says one of the calls that stood out came from a woman who had recently been hospitalized because of a chronic condition that put her at higher risk for COVID-19.

She called Loyola’s hotline seeking a test, and Green acted as a "goalkeeper," Akyar described, directing the caller to a nurse who ultimately determined she was eligible. The woman’s next step would be to get a COVID-19 test at a Loyola facility prepared to receive such patients, Akyar said, and wait for her results. In this way, the hotline is attempting to help cut down on the number of people unnecessarily physically waiting in the hospital for testing information, Akyar added.

"It’s hard because you're using your clinical judgment, but you can't give them advice," Green explained. "All I did was really just listen to her ... I validated her fears because it is a scary thing."

After reassuring the caller, Greens says she responded by saying, "You know, my mother in heaven must have connected me with you today."

"[It] amazed me and kind of made me laugh because I did not feel like I did very much except to educate her on what I knew about the disease ... and listen to her," Green said. "It made a difference."

For the Loyola medical students, staffing the hotline was a way to contribute to the health care system, which is each of their ultimate life goals.

"I know our system is being really overloaded right now," Green said. "I want to get into the fight and I want to help out."

If you would like to speak to a hotline representative about possible COVID-19 symptoms, whether you qualify for testing, or preventive measures, search online for your state’s health department or local hospital’s website.

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Irena Yoder(CEDAR RAPIDS, Iowa) -- An 18-year-old student who said he tested positive for the novel coronavirus wants the world to know that regardless of age, the respiratory illness does not discriminate.

Dimitri Mitchell, a freshman at Kirkwood Community College in Cedar Rapids, Iowa, has had no prior health complications and began showing symptoms for COVID-19 on March 13.

Mitchell told ABC News' Good Morning America it started with a cough, followed by very high fevers reaching 105 degrees.

"I was bedridden all day and I felt totally drained ... my eyes wouldn't stop watering, I had the worst headache I've ever experienced and my cough was just getting worse and worse," said the teen from Tiffin, Iowa, where there's at least 786 cases.

"It's the most sick I've ever been and I told my mom I felt like I was hit by a truck," he said.

Mitchell's mother, Irena Yoder, took him to the emergency room where they tested him for pneumonia, the flu and strep, which all had negative results.

"I was really concerned that it was coronavirus," Yoder told GMA. "He's [wasn't] meeting criteria to have this test done on him. They said, 'He's under 60 years old and he will find his body is strong and he will fight this.' So, they sent us home."

The Centers for Disease Control and Prevention (CDC) says not everyone needs to be tested for COVID-19, and most people with mild cases are able to recover at home.

The CDC lists guidance for who should be tested, but decisions about testing are made by state and local health departments and/or clinicians.

Yoder, who's a lab technician at the hospital where Mitchell was cared for, planned on staying home from work the next day to care for her son.

But that night, Yoder said, Mitchell woke her up.

"He was sweating with a fever, his eyes were so swollen, " Yoder said. "He was breathing hard. He could barely walk. He could barely speak. He was like, 'Mom what do I have?'"

"I was trying to cheer him up saying, 'It's going to be OK.' Deep inside, I was so worried,'" she said.

On March 16, Yoder brought Mitchell back to the emergency room and called the Iowa Department of Health, who recommended Mitchell be tested for COVID-19. The results were positive.

Yoder suspects her son contracted the virus while working part-time at a grocery store.

"Every 10 to 15 mins I was checking on him because he was breathing so hard and I was so scared," Yoder said.

"I never thought my son would get it," she added. "He was perfectly healthy, playing sports. So what we'll learn [is] it can hit any age of people. It doesn't ask permission."

Over a million people have been diagnosed with COVID-19 globally, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. There have been at least 67,000 deaths worldwide, with more than 9,000 in the U.S.

The World Health Organization (WHO) says people of all ages can be infected by COVID-19. Older people, and people with preexisting medical conditions (such as asthma, diabetes or heart disease) appear to be more vulnerable to becoming severely ill with the virus.

WHO advises people of all ages to take steps to protect themselves, such as good hand hygiene and good respiratory hygiene.

Among U.S. patients with known age, the CDC found 29% were 20 to 44. Five percent of cases occurred in ages 0 to 19.

A 6-week-old baby in Hartford, Connecticut, is now believed to be one of the youngest victims after being brought to a hospital in an unresponsive state and couldn't be revived, according to Gov. Ned Lamont. A test came back last week and showed the newborn tested positive for COVID-19, according to Lamont.

Two weeks ago in California, authorities said a 17-year-old boy who tested positive for COVID-19 had died, but it wasn't clear whether the virus, or underlying health issues were to blame.

Mitchell is thankfully in recovery. He still has a mild cough and has been fever-free for one week.

"Even when I heard that it spread to my home state, I still never thought that I would get it -- never in a million years," he said. "Being 18 and hearing about all the headlines saying it only affects older people, it gave me even more false security I guess. I thought I could go out and be perfectly fine."

"I think no matter what your age is regardless if you have health conditions or not, make sure you follow the social distancing guidelines," he added. "Don't treat it like you're immune and you can't get affected."

Yoder, who helped her son through his sickness, said she is now in quarantine after showing signs of COVID-19 herself.

She's urging parents to take the virus seriously and keep your children safe at home.

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Hero Cosmetics(NEW YORK) -- Acne stickers, also known as pimple patches, are used to spot treat acne breakouts.

They are typically placed on top of clean skin to help shrink or prevent pimples.

But do they actually work and what type is right for you?

What are acne stickers?

New York City-based dermatologist and author of Dirty Looks Dr. Whitney Bowe says "stickers act as a physical barrier between your fingers and your zit."

She says they are great for people who tend to pick or scratch at their breakouts.

"Picking, or popping, or any form of manual manipulation can dramatically increase your risk for hyperpigmentation, infection and scarring," Dr. Bowe told ABC News' Good Morning America.

Placing a sticker on top of a breakout can help keep bacteria away and speed up healing time.

Hydrocolloid


Many acne stickers are made from hydrocolloid bandages which help absorb fluid.

Dr. Bowe says "you can think of each pimple as a minor wound, and these bandages help stimulate them to heal."

Hydrocolloid patches are best for breakouts at the top of the skin with a visible whitehead.

Brands like Starface, Squish, Peach and Lily and Welly all make hydrocolloid patches with no other active ingredients.

Salicylic acid

Salicylic acid is a common ingredient in found in many acne-fighting products.

According to the National Center for Biotechnology Information, "the comedolytic property of salicylic acid makes it a useful peeling agent for patients with acne."

"Salicylic acid can be drying, but is incredibly effective for reducing inflammation associated with acne lesion," Dr. Bowe added.

Peace Out, Alba Botanica and Patchology make acne patches that contain salicylic acid as an active ingredient.

"We would recommend salicylic acid patches for anyone with cystic acne or new pimples not yet turned into white heads," Chris Hobson, CEO and founder of Patchology, told GMA.

Microdarts

Acne patches with microdarts are the latest spot treatment to hit shelves.

"Dissolving microneedles are a very cutting edge delivery mechanisms to increase penetration of some ingredients through the stratum corneum into the deeper layers of the skin," Dr. Bowe said.

These patches are helpful for more stubborn breakouts that are deeper under the skin.

Some of the patches contain ingredients like hyaluronic acid and niacinamide to help heal breakouts.

As per the NCBI, "because of its verifiable beneficial effects, niacinamide would be a suitable component in cosmetic products for use in disorders of epidermal barrier function, for ageing skin, for improving pigmentary disorders and for use on skin prone to acne."

ZitSticka, Dr. Jart and Hero Cosmetics have all implemented this type of microdart technology into their acne patches.

Ju Rhyum co-founder and CEO of Hero Cosmeticsm says microdarts "help deliver active ingredients to the source of the pimple and helps treat early stage zits."

The takeaway

Acne stickers are a great way to help with breakouts but should be used in conjunction with other treatments and you should always consult a dermatologist.

"Pimple patches are only used to spot treat an active pimple and should be using alongside other acne products. An acne regimen should be followed for those with acne-prone and oily skin," Tawhanna Wood, senior manager of research and development at Alba Botanica, told GMA.

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