Nearly 20 million lives were saved by COVID-19 vaccines during their first year, but even more, deaths could have been prevented if international targets for the shots had been reached, researchers reported Thursday.

On Dec. 8, 2020, a retired shop clerk in England received the first shot in what would become a global vaccination campaign. Over the next 12 months, more than 4.3 billion people around the world lined up for the vaccines.

The effort, though marred by persisting inequities, prevented deaths on an unimaginable scale, said Oliver Watson of Imperial College London, who led the new modeling study.

"Catastrophic would be the first word that comes to mind," Watson said of the outcome if vaccines hadn't been available to fight the coronavirus. The findings "quantify just how much worse the pandemic could have been if we did not have these vaccines."

The researchers used data from 185 countries to estimate that vaccines prevented 4.2 million COVID-19 deaths in India, 1.9 million in the United States, 1 million in Brazil, 631,000 in France and 507,000 in the United Kingdom.

An additional 600,000 deaths would have been prevented if the World Health Organization target of 40% vaccination coverage by the end of 2021 had been met, according to the study published Thursday in the journal Lancet Infectious Diseases.

The main finding — 19.8 million COVID-19 deaths were prevented — is based on estimates of how many more deaths than usual occurred during the time period. Using only reported COVID-19 deaths, the same model yielded 14.4 million deaths averted by vaccines.

The London scientists excluded China because of uncertainty around the pandemic's effect on deaths there and its huge population.

The study has other limitations. The researchers did not include how the virus might have mutated differently in the absence of vaccines. And they did not factor in how lockdowns or mask-wearing might have changed if vaccines weren't available.

Another modeling group used a different approach to estimate that 16.3 million COVID-19 deaths were averted by vaccines. That work, by the Institute for Health Metrics and Evaluation in Seattle, has not been published.

In the real world, people wear masks more often when cases are surging, said the institute's Ali Mokdad, and 2021's delta wave without vaccines would have prompted a major policy response.

"We may disagree on the number as scientists, but we all agree that COVID vaccines saved lots of lives," Mokdad said.

The findings underscore both the achievements and the shortcomings of the vaccination campaign, said Adam Finn of Bristol Medical School in England, who like Mokdad was not involved in the study.

"Although we did pretty well this time — we saved millions and millions of lives — we could have done better and we should do better in the future," Finn said.

Funding came from several groups including the WHO; the UK Medical Research Council; Gavi, the Vaccine Alliance; and the Bill and Melinda Gates Foundation.

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All government-mandated coronavirus restrictions in England were lifted on Thursday, including the legal requirement for people who test positive for COVID-19 to isolate at home.

Officials say that those who tested positive will still be advised to stay at home for at least five days. But, from Thursday they are not legally obliged to do so, and those on lower incomes will no longer get extra financial support to make up for a loss of income due to isolation.

The routine tracing of infected people's contacts has also been scrapped. Prime Minister Boris Johnson set out on Monday his Conservative government's strategy for "living with COVID" in the longer term. He said Britain is moving "from legal restrictions to personal responsibility," and that the end of all domestic legal measures marked the end of two of the darkest years in the country's peacetime history. 

The strategy includes plans to massively scale back free universal coronavirus testing from April 1. England already tossed most virus restrictions in January, after infection rates and hospitalizations fell following a surge in late December. Face masks are no longer legally required anywhere and vaccine passports for entering nightclubs and other venues were nixed. 

Scotland, Wales and Northern Ireland, which set their own public health rules, have similarly opened up, though at different paces.

Some other European countries,  including Denmark and Sweden, have also recently lifted all COVID-19 restrictions.

Some critics have questioned whether it is too early to end all restrictions, especially isolation laws. The British Medical Association warned that Johnson's strategy fails to protect the most vulnerable people and those at the highest risk of harm from COVID-19.

Some 85% of people aged 12 and older in the U.K. are fully vaccinated, and about 66% have had their third or booster dose. 

The U.K. still has Europe's highest coronavirus toll after Russia, with more than 161,000 recorded deaths.

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Almost anywhere with a sewer connection can help the Center For Disease Control's (CDC) system for tracking COVID-19 in wastewater.  

The CDC’s Network Wastewater Surveillance System (NWSS) includes labs to track COVID cases.

"As you can see here, there's all these tubes, and they just have 200 microliters of this clear liquid that has all the RNA and DNA from the wastewater sample," said Joaquin Bradley Silva, lab manager at UC Berkeley.

From the samples, scientists can tell how much of the coronavirus is in an area. The CDC’s NWSS project lead says they can identify it down to the zip code.

Now, they’re starting to share that information with the public on their online COVID tracker. More than 500 sites will begin submitting data in the coming weeks.

Alexandria Boehm, a professor of civil engineering at Stanford University, leads a team of researchers testing samples from wastewater processing plants across northern California.

She says the program will help move the U.S. from a pandemic to an endemic state.  

"It's really exciting that the public can see all the hard work we've been doing and maybe become more educated about how wastewater can provide a glimpse into the public health of their communities," Dr. Boehm said. 

Monitoring wastewater provides information on a population in a single sample. It also is less biased than individual case data, which may under-represent asymptomatic infections and cases in communities with lower testing rates. 

Some critics have voiced concern about the nuance of interpreting the data.  

The CDC’s project lead says their tracker’s main metric will be looking at the percentage change of concentration over a 15-day period. People can also see how many samples tested positive at a site over that same 15 days, but it won’t compare site to site. For example, users won't be able to look at California next to Washington D.C.

This is just the start for what CDC plans to use wastewater surveillance for. By the end of this year, they plan to track other health threats like influenza and E. coli.

This story was originally reported on Newsy.com.

The term "flurona" started a headline out of Israel and has been now been used across the globe.

Some misunderstood the term to mean a case of the flu and COVID-19 combining.

Dr. Jonathan Grein, an infectious disease doctor and director of Hospital Epidemiology at Cedars-Sinai Medical Center in L.A., said that's not what's happening. H said the medical diagnosis is actually a co-infection.

At this point, Dr. Grein says co-infections of flu and COVID aren’t something to panic about.

"There does not seem to be a major signal that infection with both makes you significantly more sick, but we just don't know, and it's too early to know," Grein says. "Common sense would dictate being infected with two things is certainly not good."

The common symptoms to look for include dry cough, fever, sore throat, head or body ache, and exhaustion.

Grein says his hospital has only seen a few people with flu and COVID at the same time. Just like co-infections elsewhere in the country, all the cases were mild and in younger patients, he said.

Experts say that’s because the younger people have less immunity because they haven’t been exposed to as many viruses.

Unvaccinated people who are very social, don’t mask are more likely to get a flu and COVID co-infection. Elderly and immunocompromised people are more prone to having both illnesses turn severe.

"There is a real concern that we will see more influenza that circulates along with COVID-19," Grein says. " And, I think there's a real concern that that could really increase the number of people that get severely ill or have to come to the hospital."

Medical experts encourage people to get vaccinated against the flu and COVID-19 to protect themself from the viruses.

This story was originally reported by Lindsey Theis on Newsy.com.

Ireland King and mom Michelle know the effect of the pandemic on mental health.

"I didn't want to leave my room," said Ireland King. "I didn't even feel like eating. My family felt like I didn't like them because I was so rude all the time."

"She basically came out and said she didn't wanna be here anymore," said Michelle King. "More than once."

The Indiana family is by no means alone.

"We describe it as a mental health tsunami going on," said Dr. Thomas Plante, licensed psychologist and psychology professor at Santa Clara University.

That tsunami has millions of Americans grasping for relief. Medication and therapy might be the medical solution, but that’s not always the answer.

"Some people act different to medications, it doesn't always work for people," said Heidi Strunk, president & CEO of Mental Health America of California.  

"A lot of times medication is trial and error."

Stigma, lack of equity and access and a mental health worker shortage are all challenges for people seeking help.

Experts say for the individual, there are some low-cost options.

A quick app store search shows dozens of apps, some focused on checking in with yourself, others can link you to a therapist.

Other ideas: 

• Jotting down what makes you happy 
• Getting movement or exercise 
• Journaling 
• Finding an outlet like music, video games, or art 
• Joining online or in-person support groups

"When you identify that, do it. There's power in doing what makes us happy," said Strunk. "These are things that people need to do, of course, before we get into crisis, but being proactive."

It's not just up to the individual.

"Lots of times it's really hard for people to do anything individually because they're paralyzed by the anxiety or the fear of the depression or whatever," said psychologist Dr. Thomas Plante. "And it's hard for them to really be proactive in helping themselves."

Plante says employers, bosses, family, and friends can start with a simple, "I get that."

"We need to journey with people in solidarity. You know, we need to be with them and we say, you're anxious. I get that. I get anxious, you're depressed, I get depressed," said Dr. Plante. "You know, you're feeling suicidal. I don't blame you, you know, but you know, the world is a mess."

And beyond that, people can follow up.

Another option: a warm line.

Warm lines aren’t crisis hotlines, but a tool for people before they’re in dire straits. There are more than 100 in the U.S. The majority are staffed by people like Bettye Foster, who have firsthand experience.

BETTYE FOSTER: We're all primary caregivers of someone with a mental health challenge.

LINDSEY THEIS: So even yourself?

FOSTER: Even myself. So I have a family member that I was the primary caregiver for. And some of our advocates are still that primary caregiver for someone.

It’s not a call for help, but it is a call to help. Because, as Bettye puts it:

"You see someone on the street and you're like, yeah, you don't know what's going on with that person," said Foster. "And you also don't know what's going on with the person who looks good, who looks well. You know, for that, you may think they've got it all together. You don't know, because mental illness doesn't have that kind of face."

Meanwhile, the Kings search for more help for Ireland. She’s lived through the COVID health crisis, and is now among the millions hit by the mental health crisis.

"There needs to be something. Something needs to change," said Ireland King.

"I’m not willing to let her slip through the cracks, and no other family should either," said Michelle King.

This story was originally reported by Lindsey Theis on Newsy.com.

The Food and Drug Administration on Monday granted full approval to the Pfizer/BioNTech COVID-19 vaccine for people age 16 and older. This is the first coronavirus vaccine approved by the FDA, and is expected to open the door to more vaccine mandates.

"The vaccine has been known as the Pfizer-BioNTech COVID-19 Vaccine, and will now be marketed as Comirnaty, for the prevention of COVID-19 disease in individuals 16 years of age and older," the FDA said in its announcement on Monday.

The Pfizer/BioNTech vaccine has been authorized for emergency use in the United States since mid-December for people age 16 and older. In May, the authorization was extended to those 12 and older.

"The vaccine also continues to be available under emergency use authorization, including for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals," according to the FDA.

Out of more than 170 million people in the United States fully vaccinated against COVID-19, more than 92 million have received the Pfizer/BioNTech vaccine.

This weekend, officials familiar with the decision said they discussed how to prepare for the rollout once the FDA grants full approval, given it will be a major messaging opportunity to encourage vaccination.

U.S. Surgeon General Dr. Vivek Murthy told CNN Sunday that approval could encourage more people to get vaccinated, and more mandates.

"For businesses and universities that have been thinking about putting vaccine requirements in place in order to create safer spaces for people to work and learn, I think that this move from the FDA, when it comes, will actually help them to move forward with those kinds of plans," Murthy told CNN.

Murthy also noted "a small number of people" have been waiting for full approval before getting their shot and believes "this may tip them over toward getting vaccinated."

Why emergency use authorization came first

Due to the seriousness of the pandemic, vaccine makers originally applied for emergency use authorizations because the authorization process takes less time than what's required for full approval.

In July, drugmaker Pfizer announced that the FDA granted its vaccine a priority review, and the FDA had been pulling in extra help from across the agency to speed final approval of the vaccine, an agency spokeswoman told CNN in late July.

Emergency use authorization is what its name suggests — a medical product, such as a vaccine, that gets special FDA authorization to be used during an emergency. When the health emergency is over, "then any EUA(s) issued based on that declaration will no longer remain in effect," according to the FDA.

Among the two other coronavirus vaccines authorized for emergency use in the United States, Moderna has begun applying for full approval for its COVID-19 vaccine in people ages 18 and up. Johnson & Johnson has not yet filed for full FDA approval of its vaccine.

Some experts have pushed the FDA to approve vaccines quickly, as doing so could help combat vaccine hesitancy.

Full approval of the COVID-19 shots comes days after the Biden administration announced plans to offer booster doses to vaccinated adults starting Sept. 20 — pending approval by the FDA and recommendation from the Centers for Disease Control and Prevention.

FDA approval could fight vaccine hesitancy, experts say

Progressing from authorized to approved would allow manufacturers to market and directly distribute their vaccines — and perhaps sway skeptics hesitant to get the vaccines now.

A Kaiser Family Foundation survey of U.S. adults released in July found that among the one-third of adults surveyed who are not yet vaccinated, 16% said the vaccine was too new, too unknown or not tested enough.

Some said in this poll that they wouldn't get a vaccine until it is required. While companies are allowed to require the vaccine — and many large businesses, such as United Airlines, Disney, Walmart, Microsoft, Google and Facebook already have announced plans to do so — some experts believe more will make it a requirement once a vaccine is fully approved.

The Pentagon plans to make the vaccine mandatory for all active duty members of the U.S. military by the middle of September, or sooner, based on approval timing, Secretary of Defense Lloyd Austin said in a memo released earlier this month.

"I want you to know that I will seek the President's approval to make the vaccines mandatory no later than mid-September, or immediately upon the U.S. Food and Drug Administration (FDA) licensure, whichever comes first," the memo states.

Full FDA approval may also mean big changes in terms of vaccine requirements for staff and students in schools.

For instance, in Ohio, a House bill signed into law in July states that a public school or state institution of higher education shall not "require an individual to receive a vaccine for which the United States Food and Drug Administration has not granted full approval."

Across all 50 states, at least five routine childhood vaccines are generally required for children attending childcare or school, including those for diphtheria, pertussis, and tetanus or DTaP, chickenpox, polio and MMR. But those shots have all been fully approved by the FDA.

"COVID-19 is a little bit different from these other vaccines because of the way it had to be developed," Hemi Tewarson, executive director of the National Academy for State Health Policy, told CNN in July.

"That is a difference, I think, in some people's minds who have concerns around potential side effects for children," Tewarson said, noting that clinical trials for the EUA for children 12 and older were robust, and there were not significant side effects.

But full FDA approval of the Pfizer/BioNTech COVID-19 vaccine is for people age 16 and older — it's not yet available for all ages.

What does approval mean for kids?

As of now, the Pfizer/BioNTech COVID-19 vaccine is still only available for ages 12 and older in the United States.

Pfizer has said it expects to have vaccine trial data on children ages 5 to 11 by the end of September, and the company could apply to have its vaccine authorized for those younger ages shortly after. The company also has said data for even younger children, ages 2 to 5, could be available shortly after.

Moderna and Johnson & Johnson are also working on studies in children.

"Does getting full approval for an adult vaccine, does that matter in terms of speeding up the process for approval for the childhood vaccines? I think the answer to that question is probably no," Dr. Paul Offit, a prominent member of the FDA's vaccine advisory committee and director of the Vaccine Education Center at the Children's Hospital of Philadelphia, told CNN previously.

Overall, "this is all sort of new territory — the notion of emergency use authorization obviously is new, certainly for vaccines that have been used to this extent."

We know more about the COVID-19 vaccines and the CDC has relaxed their masking guidelines in certain situations. So you might be wondering about the risks of getting sick with COVID-19 in different situations. 

We asked the experts: What’s the risk of getting COVID-19 from working out at a gym?

Their take: The risk of contracting COVID-19 is low risk, if you’re fully vaccinated.

"If you're unvaccinated and you're around other unmasked people that are potentially not vaccinated, the risk would be much higher because you could have (a) risk of exposure to somebody that could transmit COVID-19," Katie Cary, assistant vice president of infection prevention for HCA Continental Division, told Newsy. 

"So unmasked and vaccinated, the risks are going to be far lower of a severe or even mild COVID-19 illness across the board. If you are unvaccinated and there are other unmasked unvaccinated people at the gym, you're going to be a little bit higher risk of transmitting or catching a Covid 19 infection if somebody else is unmasked and carrying COVID-19 at that time," Dr. Joesph Khabbaza, a pulmonary critical care specialist at Cleveland Clinic, said. 

"One of the risks really comes down to who else is in your life or in your household that may be at risk if you get COVID-19. And this is particularly something to consider when you are at a place like a gym where you may have a large number of people now coming in unmasked. And we know that as you breathe heavier, you dispel more droplets and potentially virus into the air. And the amount of virus in the air will really depend on how good the ventilation is and how many people are there at a given time," Dr. Kelly Cawcutt, associate medical director of infection control and epidemiology at Nebraska Medical Center, said.

This story originally reported by Lindsey Theis on Newsy.com.

Seeking out mental health treatment is a major first step, often followed by that all-too-familiar question, "How am I going to pay for this?"

The cost of a therapy session ranges, depending on your access to health care coverage and even where you live in the country. But experts say, don’t let it be a hindrance. 

The Affordable Care Act requires some insurers to offer coverage for mental health services. But just like any other treatment, there could be stipulations like using in-network providers for full coverage. So it’s best to get familiar with your plan. 

And if you don’t have insurance, there are still options for affordable help.

"There are clinics out there who will try to work with you. And will do scaled pay. And for patients who really have zero resources at all, there are clinics within the county that will care for you for free, provide medications for free, they typically tend to work more closely with the homeless. But those are still options," said Dr. Eric French, medical director of adult psychiatry at the Medical Center of Aurora.

"Group support is often very useful, especially for individuals who don't have a lot of support already built in. And it can, in the case of some illnesses, it can take the place of psychotherapy," said Dr. Flavia Desouza, a board certified psychiatrist and assistant professor at Howard University. 

"There is an emergence of mental health services that are also offered in church settings as well. Sometimes colleges or universities will have therapists in training, who have much cheaper rates and who are being supervised by someone. So that can also be another option," suggested Nii Addy, a neuroscientist and host of the Yale University Podcast Addy Hour. 

There’s also findtreatment.gov, a search engine run by the federal government that can direct you to affordable options near you. When it comes to medication, you have to shop around. Experts recommend price comparison sites like GoodRX. And groups like the National Alliance on Mental Illness which can serve as a road map to affordable options.

"NAMI and other places can actually facilitate some of that conversation, to make sure that people do get plugged into those resources," said Addy. 

While it may take some homework and research, experts agree the payoff could be worth it in the long run.

This story originally reported by Amber Strong on Newsy.com.

CINCINNATI -- Sex is a tough subject to discuss for a lot of people, especially when there's some kind of dysfunction.

It's a very real complaint for women who go through breast cancer treatments. But there may be a bit of hope on the horizon, as UC Health is running a study on a laser that could help breast cancer survivors.

Last year, Julie Snyder was among the 250,000 women who got an invasive breast cancer diagnosis. She had a lumpectomy, chemo and radiation -- with side effects.

"One of the big ones was the sexual side effects of drying out," she said. 

That makes intimacy difficult because, under those circumstances, sex can cause tearing and bleeding.

"My husband and I had a great sex life before breast cancer, and he stuck by me the whole time," Snyder said. "He was awesome. It makes you even closer."

That's why Snyder enrolled in a clinical trial at UC Health that's trying to see if a laser can treat vaginal dryness, to help restore a normal love life.

Dr. James Whiteside is one of the leaders on the study, examining how effective the laser may be.

"What we're trying to do is create a new therapy that will be hope for this problem," he said.

Nurse practitioner Cindy Dehlinger explained that the laser damages tissue and encourages the cells to repair themselves, and it builds collagen. 

"The laser is a non-hormonal therapy that may be more effective than the topical agent with lidocaine," (a local anesthetic) Whiteside said.

Snyder said the results have been "amazing."

Whiteside said they're still enrolling patients in the trial, with a goal of 70 total. Any potential patients should keep in mind that results may vary. Anyone interested in participating can call 513-584-4100.

CINCINNATI -- At first, it seemed like 4-year-old Elijah Peacock had caught a cold. But his symptoms morphed into something much more serious.

"I never understood lethargia till I saw it in my son," Elijah's mom, Alex Voland, said. "We went to stand him up, and he collapsed."

The illness left Elijah with lower limb paralysis. Now he's in a wheelchair.

Doctors at Cincinnati Children's Hospital Medical Center said Elijah's symptoms match acute flaccid myelitis, though his case has not been confirmed as that condition. 

Watch doctors discuss the case in the video player below:

 

According to the CDC, acute flaccid myelitis is "a rare but serious condition" that affects spinal cord gray matter and causes muscles and reflexes to weaken. 

CDC officials said they started seeing an increase in cases in 2014. There have been 219 reports and 80 confirmed cases of the condition in the U.S. this year, as of Nov. 2. Those cases are spread across 25 states. 

In Ohio, there have been five confirmed cases this year, compared to just two in 2017 and two in 2016. The 2017 cases were confirmed in Butler and Hamilton counties, and one of the 2016 confirmed cases was in Adams County.

Most of the patients with acute flaccid myelitis are children, according to the CDC.

Symptoms of acute flaccid myelitis include facial droop/weakness, difficulty moving eyes, drooping eyelids and difficulty swallowing or slurred speech, according to the CDC. 

Doctors don't believe acute flaccid myelitis is contagious, according to Children's Hospital officials. However, the exact cause of the disease — likely a virus — has not been determined. 

Check back for more information.