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Health News

jarun011/iStock(WASHINGTON) -- The United States is not ready to declare the new coronavirus a public health emergency, health officials said Tuesday, although the option is available should the situation in the U.S. change.

"I'll do it when it's appropriate," Alex Azar, Secretary of Health and Human Services said during a Tuesday news conference.

"It's very important to remember where we are right now," Azar continued, noting that only five people in the U.S. have been diagnosed with coronavirus, all of whom traveled to Wuhan, China. There's been no evidence of human-to-human transmission documented in the U.S. so far.

Several Congress members have called on HHS to declare coronavirus a public health emergency in order to free up additional CDC funding to address the virus.

The death toll from the novel coronavirus has continued to climb in China as the outbreak spreads, with now at least 106 people dead and over 4,500 confirmed cases.

The number of dead from the new viral disease includes the first death in the Chinese capital, Beijing, along with two dozen others in central China's Hubei province, where the first cases were detected in December.

The epicenter of the outbreak is in Wuhan, the sprawling capital of Hubei province, which Chinese authorities have placed on lockdown in an effort to contain the disease. With the influx of patients seeking treatment, the city is racing to build a brand new 1,000-bed hospital, which is slated to be completed by Feb. 3. A second 1,300-bed hospital is expected to be finished later in February.

Hong Kong leader Carrie Lam announced at a press conference Tuesday that train service to mainland China will be halted, starting at midnight Thursday. Lam said two train stations connecting the semi-autonomous Chinese city to the mainland would also be closed and some flights would be cancelled.

The outbreak has also spread overseas, with cases confirmed in more than a dozen other countries, including in the United States.

The U.S. Consulate in the central Chinese city of Wuhan, the epicenter of the outbreak, will evacuate its staff along with their families and some other Americans on Wednesday morning, a spokesperson for the U.S. Department of State. The spokesperson told ABC News that the charter flight will travel to California's Ontario International Airport, where all those on board will be screened for symptoms at the airport prior to leaving and also will be subject to additional screening, observation and monitoring requirements by the U.S. Centers for Disease Control and Prevention.

The U.S. Department of State issued a new travel advisory on Monday urging Americans to reconsider travel to any part of China due to the disease, rather than just Wuhan and other affected areas. U.S. citizens are advised not to travel to Hubei province.

The new coronovirus causes symptoms similar to pneumonia that can range from mild, such as a slight cough, to more severe, including fever and difficulty breathing, according to the U.S. Centers for Disease Control and Prevention.

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Pureradiancephoto/iStock(NEW YORK) -- Opioid-related overdose deaths are on the rise, but individuals aged 15 to 24 have experienced a decline in treatment from the lifesaving medication buprenorphine, a new study finds.

Buprenorphine is a U.S. Food and Drug Administration-approved treatment for opioid addiction. Researchers made their findings at Columbia University College of Physicians and Surgeons in New York City by analyzing national data regarding buprenorphine prescriptions filled by people aged 15 to 80 years.

“Findings from the new study reveal that we have been making progress; between 2009 and 2018 the number of Americans who were treated with buprenorphine increased from 0.4 to 1.1 million,” said study leader Dr. Mark Olfson, professor of psychiatry, medicine and law at Columbia University.

However, use of the medication fell in the youngest group from 1.76 to 1.40 per 1,000 people, which is about 20%.

The findings also showed that the prescription strength and length of buprenorphine treatment were also lower among those aged 15 to 24 than among older Americans.

"These findings for young people are particularly worrisome, given that their decrease in buprenorphine treatment occurred during a period when there was an increase in opioid-related overdose deaths for this age group," Olfson said in a university news release.

Per Dr. Rais Vohra, UCSF Professor of Emergency Medicine and Clinical Pharmacy at UCSF Fresno as well as Medical Director of the Fresno/Madera Division of the California Poison Control System states that, “one reason why buprenorphine treatment isn’t increasing among young people is that many addiction centers as well as psychiatrists only treat adults and few pediatricians have a waiver to prescribe it.”

Current policy restricts the use of buprenorphine by requiring physicians to obtain a special “X waiver” before prescribing it by going through training and agreeing to limits on the number of patients they will treat.

Olfson went on to state that, “some physicians may be reluctant to prescribe buprenorphine to younger people with serious opioid problems because they prefer to try detox followed by drug-free approaches first rather than trying to maintain them on buprenorphine, which is an opioid.”

The problem with this approach is that detox followed by drug free approaches are typically less effective than an FDA approved medication such as buprenorphine.

According to the National Institute on Drug Abuse, every day more than 130 people in the United States die after overdosing on opioids which includes prescription pain relievers, heroin, and fentanyl.

"Our results highlight the critical need to improve buprenorphine treatment services, especially for the youngest with opioid use disorder," Olfson said.

“Fortunately there are programs like the California Bridge Program that are working to improve the landscape by creating 24/7 access points where any patient with opioid addiction can walk into an emergency room and start addiction treatment right away,” said Vohra. “At the same time they are also working to train doctors to be X waivered to truly curb this epidemic.”

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PeopleImages/iStock(NEW YORK) -- A baby's first words are an important milestone for many parents.

However, for some kids dubbed "late talkers," parents may be left worried and turn to speech therapists for help.

Instead of having to travel to a doctor's office, some parents opt for a more accessible way to help their kids by seeking advice from speech therapists like the Speech Sisters -- Brooke Dwyer and Bridget Hilsberg -- on Instagram.

The sisters have 20 years of combined experience and have run a private practice for eight years, working with hundreds of families to help get their kids who are late talkers communicating.

"A late talker is a child who understands language, but they're just not meeting their communication milestones," Dwyer told ABC News' Good Morning America. "So they probably don't have as many words as they should have for their age."

On their Instagram, Brooke and Bridget share practical tips for parents to help get their kids chatting.

They even offer courses for parents on their website, like the "Late Talker Course" and the "Talk On Track" course, that parents can start with their little ones from birth to 14 months so they can learn to meet language milestones.

For Christine Levin's 18-month-old son Everett, the Speech Sisters' methods worked, ultimately helping him grow his vocabulary from just five words to 35.

"It feels good to see your son's language grow and have him happy and able to communicate," Levin told GMA.

Here are some of their tips to help get babies talking:

1. Baby talk is beneficial

While there are mixed opinions about baby talk, the Speech Sisters say that it can be beneficial if used the right way. According to Bridget and Brooke, baby talk, also known as "motherse," "parentese" or "infant-directed speech," helps babies learn. And when you speak to babies in this manner, they become more engaged.

The right way: Use a high-pitched, exaggerated speech containing real words and correct grammar like, "You want water in your cup?"

The wrong way: using made up words with incorrect sounds or grammar. It may sound like this, "You want a 'wittle' wawa in your 'cuppie'?"

2. Read with your baby

Reading with babies is one of the best ways to keep them engaged so they can learn more language, the Speech Sisters say.

And the best way to do this is to read to them when they are facing you. When a baby is facing you, they're able to watch your mouth as you say the words and see your expressions and gestures. By facing each other, you're making reading more interactive and research shows that having back-and-forth interactions improves language.

Another tip that Bridget and Brooke encourage parents to try is to make the book "come alive" by being silly and having fun.

"If there is a glass of water in the book, drink it! If there is food in the book, eat it! And you don't have to read all the words when your baby is little, just highlight a few key words," they said.

3. Again and again

The first instinct for many parents trying to get their kids to talk is to repeatedly say a word or an object, like, "Say 'truck,' say 'truck.'" While it's natural to resort to this, the Speech Sisters say it puts pressure on babies.

Instead of telling kids to say anything repeatedly, it's best to repeat a word at least five times during an interaction, that way more opportunities are given for babies to learn.

4. Parents need to wait

Another instinct that parents turn to is finishing sentences for their kids when they don't talk for themselves.

"It's unnatural," said Brooke. "It's hard to wait, you wanna talk for him, especially when he's not talking for himself."

So instead of speaking for your child, Brooke and Bridget say to wait about five to 10 seconds to give them the opportunity to talk. And if they're not saying anything after that time is over, you can give them the word.

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mrtom-uk/iStock(ATLANTA) -- While the death toll for the new coronavirus has crossed 100 people people in China and put the world on edge, it is not spreading in the U.S., health officials said in news conference Monday.

"We understand that many people in the Unites States are worried about this virus," said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases (part of the Centers for Disease Control and Prevention).

"At this time, in the U.S., the virus is not spreading in the community," she added. "For that reason we continue to believe that the immediate health risk from the new virus to the general public is low at this time.”

In the U.S., 110 individuals from 26 states are being investigated to determine whether they have coronavirus. Of those individuals, 32 have tested negative, five have tested positive, and the remaining test results are pending.

No new coronavirus cases have been diagnosed overnight, according to the CDC, and all five cases were in people who had traveled to China. Two of those five cases are in Southern California and Chicago, Washington state and Arizona have each reported one coronavirus case.

The CDC is currently advising Americans to avoid non-essential travel to China's Hubei Province and Wuhan, which is the epicenter of the outbreak. Travelers to China, particularly older adults and those with underlying health problems, should discuss their travel plans with their health care providers. Anyone traveling in China should avoid contact with sick people, and should avoid animals, animal markets and animal products, such as uncooked meat. They should also wash their hands thoroughly and often.

The State Department issued a new travel advisory Monday, urging U.S. travelers to "reconsider travel" to China because of coronavirus.

Five U.S. airports, in New York, San Francisco, Los Angeles, Chicago and Atlanta, continue to screen passengers from Wuhan for pneumonia-like symptoms, such as fever and respiratory problems. So far, airports have screened about 2,400 passengers, with screenings declining following strict travel bans and a quarantine in Wuhan.

The purpose of those airport screenings is two-fold, according to Messonnier. Health officials want to quickly detect and respond to respiratory illness in travelers coming from Wuhan. They also want to educate travelers who've been to Wuhan, so that if they develop symptoms later, they know to call their health care provider to get checked out.

The CDC is in the process of developing a real-time diagnostic test to identify the virus and is hoping to quickly roll that test out to states. For now, all samples are being sent to the CDC in Atlanta, a process which takes about a day, from the time clinicians and the CDC agree to test a patient for coronavirus until results come back from Atlanta. Other countries are doing similar centralized testing, Messonnier explained. While speed is important, accurate testing is the agency's priority.

While a report in the Lancet, published Jan. 24, suggested that people who contract coronavirus might be able spread the disease before they develop symptoms, Messonnier maintained that the CDC has "no clear evidence" of patients' being infectious before symptom onset. For now, the virus' incubation period is believed to be between 2 and 14 days.

In China, where the coronavirus outbreak began, there have been more than 4,535 cases and 106 deaths. In addition to the cases in the United States, Thailand, Hong Kong, Taiwan, Australia, Macao, Singapore, Japan, South Korea, Malaysia, France, Germany, Vietnam, Nepal and Sri Lanka have all confirmed travel-related cases in their respective countries.

Sen. Chuck Schumer, D-N.Y. urged the Department of Health and Human Services to declare a formal public health emergency in the United States. Such a designation would free up money for the CDC to preemptively prepare for the virus to potentially spread in the U.S.

"If we have learned anything from the risks the new viruses pose to public health, it is a 'stitch in time saves nine,' and the more we can do to be proactive, the better off the public will be," Schumer said during a news conference Jan. 26.

A recent budget deal negotiated by Schumer and Rep. Nita Lowey, chairwoman of House Appropriations Committee, increased the federal Infectious Disease Rapid Response Reserve Fund from $50 million to $85 million, but in order to use that money, HHS has declared a public health emergency.

"The critical thing about these specific dollars is that the CDC has full discretion," Schumer said. "The agency can use them for whatever activities it deems appropriate, so long as they inform Congress. This kind of flexible funding needs to be unlocked now should this outbreak worsen."

The World Health Organization did not declare a public health emergency of international concern last week, after deliberating for two days over the decision.

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OLJensa/iStock(NEW YORK) -- Say what you want about social media, but it from time to time, it saves lives.

Such was the case when Shelby Dunham realized her daughter was choking.

"I look over and her face was turning blue and she was trying to gasp for air but she couldn't. She looked frantic. So in that moment, I completely panicked," Dunham told Good Morning America.

But she said suddenly, "I realized I knew what to do," thanks to a video on Instagram from ER nurse Shannon Tripp.

Tripp -- a pediatric nurse and mom of four -- had to save her own son, Jack, when he was just 9 months old and choked on a piece of hard candy he had accidentally gotten a hold of. Tripp gave him back blow after back blow until finally, the peppermint came shooting out.

"I thought to myself, 'What if a mom hadn't known what to do?' I would have lost my son," Tripp told Good Morning America.

That night, she recorded a video to teach other moms what to do if that happened to them. She now regularly shares medical tips on her Instagram account. That video was eventually seen by Dunham and 500,00 other people.

"I dropped her on the ground and I did exactly what Shannon's demonstration says to do," Dunham said. "And within seconds it was out and she was fine. And we both just cried and I was so thankful. It was 100% because of Shannon's highlight," Dunham said.

Signs of choking


Dr. Jennifer Ashton said the first sign is bluish discoloration around the lips. "That is a critical sign that they are not getting enough oxygen," she told GMA.

Other signs: chest and ribs are pulling inward; unresponsive or unconscious; and an inability to cry.

Ashton gave an overview CPR lesson that can be viewed here, but she encourages all parents to learn for themselves, saying, "It could save a life."

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jarun011/iStock(NEW YORK) -- The Trump administration is being urged to declare a formal public health emergency as a fifth case of the deadly coronavirus in the United States was confirmed and the death toll from the disease rose to 80 in China, where officials cautioned that the spread of the never-before-seen illness appears to be getting stronger.

Sen. Chuck Schumer, D-N.Y., is asking Health and Human Services Secretary Alex Azar to declare a public health emergency to free up money for the Centers for Disease Control and Prevention to battle the virus before it becomes an American pandemic.

"If we have learned anything from the risks the new viruses pose to public health, it is a 'stitch in time saves nine,' and the more we can do to be proactive, the better off the public will be," Schumer said during a news conference on Sunday.

“The CDC has been doing a tremendous job so far at being proactive and working around the clock to protect public health, but if we are going to make sure they can sustain this pace and remain at-the-ready should the outbreak get worse, they will need immediate access to critical federal funds that at the present time they remain unable to access," Schumer said. "That is why, today, I am urging HHS to follow the CDC’s proactive lead: declare a formal public health emergency for the coronavirus."

Schumer's request comes as the latest U.S. cases of the virus were announced over the weekend. A patient in Arizona and two in Southern California tested positive for the virus, which has caused worldwide alarm, officials said.

Health officials in Orange County, California, and Los Angeles County announced they are each treating one patient for the virus. The patient in Arizona is a student at Arizona State University but does not live in university housing, according to the Arizona Department of Health Services and the Maricopa County Department of Public Health.

The Orange County, Los Angeles County and Arizona patients, who were not identified, had all recently returned to the United States after traveling in Wuhan, China, the epicenter of the illness, authorities said. All three patients were in isolation at undisclosed hospitals, officials said.

The local officials are working with the CDC and the California Department of Public Health to reach people who have come in close contact with the patients.

"There is no evidence that person-to-person transmission has occurred in Orange County. The current risk of local transmission remains low," Orange County officials said in a statement.

The California cases follow one near Seattle, where a man in his 30s was hospitalized after being diagnosed with the coronavirus, officials said. Tests also confirmed that a woman in her 60s in Chicago had contracted the disease, officials said. Both patients had recently traveled to China.

Health authorities in Texas are investigating a suspected coronavirus case in a Texas A&M student, according to the local health department. The student, who recently traveled to Wuhan, went to an emergency department Wednesday with a cough and congestion.

Surveillance for the coronavirus at international airports in the U.S. has intensified, with airports in New York, San Francisco, Los Angeles, Atlanta and Chicago screening travelers from Wuhan.

Symptoms of the coronavirus resemble pneumonia and include difficulty breathing, fever and lesions on the lungs, which are revealed through chest X-rays, according to the CDC. Other symptoms mirror the flu and include a runny nose, headaches, coughing, a sore throat and fever, according to the CDC.

By comparison, influenza has killed 8,200 people in the United States, including 54 children, since the flu season began in October, according to preliminary estimates released by the CDC on Friday. The agency estimated that so far this season there have been at least 15 million flu illnesses with 140,000 of the cases prompting hospitalizations.

Schumer said a recent budget deal he and Rep. Nita Lowey, chairwoman of House Appropriations Committee, negotiated boosted the federal Infectious Disease Rapid Response Reserve Fund from $50 million to $85 million.

But the CDC cannot access the funds until the Department of Health and Human Services declares a public health emergency, Schumer said.

“The critical thing about these specific dollars is that the CDC has full discretion," Schumer said. "The agency can use them for whatever activities it deems appropriate, so long as they inform Congress. This kind of flexible funding needs to be unlocked now should this outbreak worsen.”

The Public Health Agency of Canada announced on Sunday that the country is dealing with its first case of coronavirus in a patient in the Province of Ontario.

"The patient who recently returned from Wuhan, China, is isolated and under care," Canadian health officials said in a statement.

Dr. Theresa Tam, chief public health officer of Canada, said the case was not unexpected.

"Although we now have a case in Canada, the risk to Canadians remains low," Tam said at a news conference.

Besides Canada and the United States, health officials in France, Australia, Japan, Malaysia, Nepal, Singapore, Thailand, Vietnam and South Korea have confirmed cases of coronavirus.

At least 80 people have died from the virus in China, and tests have confirmed that another 2,744 people in the country have contracted the illness.

The majority of the cases have been found in Wuhan, the capital of Central China’s Hubei province and a city with a population of more than 11 million people. About 9 million people in the city have been put on lockdown as a precaution, Wuhan Mayor Zhou Xianwang revealed said at a news conference on Sunday.

Meanwhile, authorities in Hong Kong have banned anyone who has been in the Hubei province in the last 14 days.

Coronavirus, a family of viruses that include SARS, MERS and the common cold, can jump from animal to human hosts.

Scientists have competing theories about the animal source behind the virus. In addition to bats, which scientists have speculated about since the beginning of the outbreak, and which were implicated in the SARS outbreak, a group of researchers published a paper last week, theorizing that snakes are the most likely reservoir behind the outbreak. Neither theory has been confirmed.

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LanaSweet/iStock(NEW YORK) -- Plant-based diets are already one of the major wellness trends of 2020.

Burger chains from McDonald's to Burger King are now offering plant-based burgers, restaurants have developed plant-based menus and meat was taken off the menu at this year's Golden Globes.

The term plant-based is everywhere, but what does it really mean and how can the diet affect your health?

ABC News' Good Morning America went to four experts for answers.

What is a plant-based diet?

A plant-based diet is a way of eating that consists mostly or entirely of foods derived from plants, including vegetables, grains, nuts, seeds, legumes and fruits.

Thomas Colin Campbell, a Cornell University biochemist, claims responsibility for giving the plant-based way of eating its name. He said he coined the term in 1980 to "help present his research on diet to skeptical colleagues at the National Institutes of Health," according to The New York Times.

"I wanted to emphasize that my work and ideas were coming totally from science and not any sort of ethical or philosophical consideration," he told the newspaper.

Is a plant-based diet different from a vegan diet?

Yes, a plant-based diet consists of eating few to no animal foods, while a vegan diet eliminates all animal foods and products -- everything from meat and leather products to eggs and cheese, according to Fatima Cody Stanford, MD, an obesity medicine physician scientist at Harvard Medical School.

Plant-based diets are also different from vegetarian diets, which eliminate all meat, fish and poultry, according to Stanford.

While religious, cultural, or ethical reasons often motivate veganism and vegetarianism, plant-based diets are often done for health and environmental reasons.

Plant-based diets also often place an emphasis as well on whole foods.

"There is a way to be healthy in any of those," said Stanford. "What I say to my patients is to find the best right thing for them because everyone’s body is different and everyone’s body responds differently."

What are the benefits of plant-based eating?

Everything from better blood pressure to better skin, according to Maya Feller, a New York-based registered dietitian.

"Those who follow a whole foods plant-based diet tend to have better metabolic profiles, like improved fasting blood sugars, lower circulating blood lipids and better blood pressure, as well as a reduced risk of developing chronic illnesses," she told GMA earlier this month. "Plus, many of the vitamins, pigments and phytochemicals in fruits and veggies contribute to healthy skin, like the lycopene in tomatoes that helps protect skin from sun damage, and vitamin C in sweet potatoes, which smooths wrinkles by stimulating the production of collagen."

"Cutting back on animal products also means skipping much of their saturated fats, which are notorious for clogging pores," she added. "On top of the health benefits, eating plant-based cuts down on animal products, which helps combat climate change."

Why is there so much interest in plant-based diets?

Plant-based diets have been steadily gaining acclaim for the last several years, often landing atop the annual best diet rankings from U.S. News & World Report.

The 2011 documentary Forks Over Knives also really put plant-based diets into the mainstream. The documentary was made by Brian Wendel, who attended a conference on nutrition in 2001, began to follow a plant-based diet and then brought the idea to the masses with the documentary and a best-selling book.

"The information has been there for a long time, at least from a health perspective, and we’ve just helped bring it to a mass audience," Wendel told GMA. "I became convinced of the health argument back in 2001 and just did it overnight. Up until that point, I had been eating animal products every day."

More recently, another documentary, The Game Changers, has pushed plant-based diets into the spotlight. The 2019 documentary, produced by James Cameron and Arnold Schwarzenegger, shows the journey of a former MMA fighter who gives up meat.

Another factor is the argument that eating plant-based is better for the environment, according to Deirdre K Tobias, assistant professor in the department of nutrition at Harvard School of Public Health.

"We see how much land it takes to supply and grow a single hamburger, for example," she said. "I think that awareness has been really eye-opening for a lot of people who may have disregarded the dietary advice for health reasons."

What are good things to eat on a plant-based diet?

Wendel, of Forks Over Knives, places an emphasis on eating whole, minimally processed foods within a plant-based diet.

"For me the best guide is does the food still look somewhat like it does when you take it out of the ground? When you cook a potato, it still looks like a potato," he said. "The more a food is like that the more you can lean on that in your diet and lifestyle, for health benefits."

Of course fresh vegetables and fruits are a big part of a plant-based diet, as well as nuts, whole grains, legumes, even seafood and the occasional meat product.

Wendel emphasizes eating more than just vegetables on a plant-based diet to ensure you are taking in enough calories.

"Make starchy foods -- beans, rice, sweet potatoes, quinoa, chickpeas -- the center of the plate because that has the energy to sustain you," he said. "And then surround it with vegetables."

What about all the packaged foods advertised as 'plant-based'?

The emphasis on eating whole foods on a plant-based diet raises the question of what to make of all the packaged plant-based products on the market, from kale chips to meat-free burgers.

"So many diets that are restrictive or have a buzz name have nothing in their description about the quality of their food, and that’s something that is really important," said Tobias. "A lot of these plant-based products might still be highly processed and have a lot of sodium and saturated fats."

"Be careful about plant-based being used as a marketing tool," she said.

Tobias recommends being a "savvy shopper" and shopping for your plant-based diet in part of the grocery store where fruits and vegetables live, the produce aisle.

"Make your own plant-based foods because vegetables are there for you," she said. "You don’t have to be purchasing packaged, processed foods."

Are there any downsides to a plant-based diet?


Not really, according to the experts.

"For heart disease, diabetes, cancer, all of the major chronic diseases, there are no downsides to eliminating meat products from your diet for any of those," said Tobias. "If anything, the evidence shows that by going plant-based you would be benefiting your long-term survival and reducing the risk of those diseases."

"Fruits and vegetables, fiber, nuts and legume have also all been proven to be good for weight loss and to keep weight off long-term," she said.

Is there a way to be plant-based but still eat some meat?

Yes, the definition of plant-based is that your diet is based on plants but allows room for other foods from time to time.

"If you’re not ready to give up meat entirely, still even reducing it to once in a while would have a lot of great benefits," said Tobias. "The science isn’t there to say a steak or a burger once in a while is horrible for you, it’s the daily consumption that’s problematic."

One option is the flexitarian diet which encourages people to try alternative meat options, like tofu, but leaves room for flexibility if you can't quite fully give up meat. The diet was promoted by dietitian Dawn Jackson Blatner in a 2009 book that says you can reap the benefits of a plant-heavy diet even if you eat meat occasionally, according to U.S. News and World Report, which ranked the diet number two on its 2020 best diets list.

This plant-heavy diet focuses on adding five food groups -- "new meat," fruits and vegetables, whole grains, dairy and sugar and spices -- to your diet, instead of taking foods away.

The "new meat" food group includes tofu, beans, lentils, peas, nuts, seeds and eggs, according to U.S. News and World Report.

Do I need to take supplements on a plant-based diet?

One of the biggest questions around a plant-based diet is whether it can provide enough protein, according to Wendel.

His take is that, yes, it absolutely can.

"I think anyone on a plant-based diet will tell you that getting protein is not hard to do," he said. "And there really is no evidence that you need a concentrated source of protein as long as you are eating enough calories and eating whole, healthy foods."

"We [at Forks Over Knives] talk about just eating the right kinds of foods, just getting enough calories in and from there nature has it figured out," Wendel added.

Plant-based sources of protein include everything from legumes and vegetables to nuts, hemp seeds and grains like lentils, beans and quinoa.

Further down the spectrum from plant-based, if you are following a strict vegan diet it is necessary to take vitamin B12, according to Stanford.

Vitamin B12 is not made by the body and is found in animal-based foods, which is why a supplement is needed, she explained.

How do I know if a plant-based diet is right for me?

All the experts agreed that you'll know a plant-based diet is working for you if you feel well and you are able to stick to it long-term.

"Your body has the answers," said Stanford. "Pay attention to your body and don’t pay attention to someone else and how they say their body responded."

The experts also noted there may be some trial and error involved so stay open to finding what works best for you.

What if I think eating vegetables seems so boring?


All the experts also dispelled the myth that a plant-based diet is boring or tasteless, citing the availability now of creative and unique plant-based recipes online and in cookbooks.

"If you’re new to eating vegetables, there are a lot of ways to make them delicious other than the steamed broccoli that you might think of," said Tobias. "There are so many ways to make vegetables and fruits and grains delicious."

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iStock(NEW YORK) -- The U.S. has now confirmed four cases of the coronavirus in U.S. patients this week. Two patients are located in California, one in Washington state and one in Chicago.

All of the patients had traveled to Wuhan, China, the city at the epicenter of the coronavirus outbreak.

 Authorities in Wuhan, China, imposed quarantine-like restrictions on the city of 11 million Jan. 21, as they raced to stop the spread of a new coronavirus that's popping up in countries around the world. Those restrictions were extended to additional cities later in the week, cutting off travel to more than 20 million people during Chinese New Year, when millions were expected to be traveling.

In Wuhan, where hospitals are struggling to keep up with the influx of patients seeking treatment, the city has broken ground on a brand new 1,000-bed hospital, which is fast-tracked to be completed by Feb. 3.

As as the situation rapidly unfolds, here's what you need to know:

How is the virus transmitted?

Chinese health authorities confirmed that the virus has been transmitted between humans Jan. 20, increasing concern over the millions of people expected to travel for Chinese New Year Year this week.

While many of the original reports of the virus in Wuhan were among people who worked at or visited a seafood and live-animal market, cases among people who weren't connected to the market have mounted in recent weeks.

That market was closed and fumigated on Jan. 1.

There is evidence of "limited human-to-human transmission" of the new virus, according to the World Health Organization, but not enough to evaluate the extent of that human transmission.

Adding to concerns are 15 cases of the disease in health care workers in Wuhan, which health experts previously said was a key population at risk for being sickened, as they were during previous outbreaks of SARS and MERS.

The new coronavirus is in the same family as SARS, MERS and the common cold. Coronaviruses often circulate among animals and can jump from animal to human.

In rare cases, those viruses can mutate and spread from person to person.

How many people have been affected?

As it stands, more than 2,500 cases of the new coronavirus have been reported in China, Thailand, Japan, South Korea, Taiwan, Vietnam and the United States, with the overwhelming majority in China. All cases reported internationally were exported from Wuhan.

Fifty-six deaths have been reported in China.

What should I know about the coronavirus cases in the U.S.?

The first case of coronavirus reported in the U.S. was in a patient in his 30s from Washington state, the CDC announced Jan. 21. Laboratory testing at the CDC in Atlanta confirmed the patient was infected with it. He's currently hospitalized, in good condition, health officials in Washington said.

Although the patient had traveled to Wuhan, he said did not visit the market at the center of the outbreak.

A second case, in a Chicago resident in her 60s, was announced during a CDC news conference Friday. She had similarly traveled to Wuhan.

"We understand that some people are worried about this virus and how it may impact Americans," said Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases.

"The immediate risk to the U.S. public is low at this time," Messonnier said.

Two cases reported this weekend are from Californian, one in Los Angeles County and another in Orange County.

How is the world responding?

Countries around the world have stepped up airport screenings in response to the rapidly evolving outbreak.

The U.S. has been screening passengers arriving from Wuhan in San Francisco, Los Angeles and New York airports since Jan. 17, and has since expanded those screenings to Chicago and Atlanta airports, according to CDC officials.

Airports in Sydney, Singapore and Moscow also will be conducting screenings.

Hong Kong's Cathay Pacific airline has been distributing face masks and antiseptic wipes to passengers traveling from Wuhan to Hong Kong, and China Air has issued flight waivers to passengers flying to or from Wuhan.

North Korea announced it would be closing its borders to foreign tourists until further notice beginning on Wednesday.

The World Health Organization met in Geneva this week to determine whether to declare the new coronavirus outbreak a public health emergency of international concern. After two days of deliberation, the committee decided not to declare a public health emergency.

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jarun011/iStock(CHICAGO) -- A second U.S. case of the new coronavirus has been confirmed in a patient in Chicago, according to the Centers for Disease Control and Prevention.

The patient, a woman in her 60s and a Chicago resident, had traveled to Wuhan, China, in late December. She was admitted to the hospital and is in stable condition, according to Illinois health officials.

The patient called her doctor ahead of time before seeking treatment and has not taken public transportation or attended any large gatherings, Dr. Allison Arwady, commissioner of the Chicago Department of Public Health said Friday.

"This is a single travel-associated case. Not a local emergency," Arwady said. "There is no need for the general public to change their behavior in any way based on this news."

"We understand that some people are worried about this virus and how it may impact Americans," Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases said at a Friday news briefing.

"The immediate risk to the U.S. public is low at this time," Messonnier said.

Sixty-three people in the U.S. from 22 states are being evaluated to determine if they have coronavirus. Of those individuals, 11 have tested negative and two have tested positive for the virus. In New York State, four people are being tested for coronavirus, Gov. Andrew Cuomo said at a news briefing Friday. Of those four, one individual tested negative for the virus and three others are waiting for diagnostic test results.

Patient samples are currently being tested at the CDC in Atlanta, and health officials are working to get those tests to states, which would speed diagnosis times.

As of Jan. 23, roughly 2,000 passengers entering the country had been screened at airports. No cases of coronavirus have been detected from the airport screenings so far.

U.S. health officials reported the first U.S. case of the coronavirus Jan. 21, when it was diagnosed in a Washington state man in his 30s who had recently traveled to Wuhan.

A total of 830 cases of the coronavirus have been reported to date in China. In addition, China's National Health Commission reports that three cases have been reported in Thailand, two have been reported in Vietnam, and one case apiece has been reported in Japan, Singapore and South Korea.

Hospitals in Wuhan overwhelmed by influx of patients


Hospitals in China are scrambling to treat the large influx of patients seeking treatment. “Shortage of medical supplies, request help!” Wuhan's Children's Hospital posted on Weibo, China's social network, in a plea for items like surgical masks, disposable clothing, gloves and goggles. Several other hospitals have posted similar requests.

In the meantime, Wuhan broke ground on a brand new, 1,000-bed hospital to address the outbreak, expected to be completed by Feb. 3. The city is following in the footsteps of Beijing, where a similar fast-tracked hospital was built to address the 2003 SARS outbreak.

U.S. State Department issues China travel warning


This announcement comes as the U.S. State Department is warning Americans not to enter China's Hubei province due to the coronavirus, as Chinese authorities announced Thursday that the death toll from the virus has increased to 25.

The U.S. is also pulling out most of its diplomats and their families from the consulate general in Wuhan, the Hubei city of 11 million where cases of the new virus were first discovered.

The State Department issued a new travel advisory late Thursday, declaring the Hubei region Level 4, Do Not Travel, the strongest of the four travel warning levels issued by the U.S. government. That puts it on par with hot spots and war zones like North Korea, Syria, and Iran.

China's National Health Commission announced Thursday that the death toll from the virus has increased to 25 from the previously-reported total of 17.

In response to the virus, officials at Shanghai Disneyland said that the giant theme park would close until further notice “in order to ensure the health and safety of our guests.” The move comes during one of the park's busiest weeks of the year.

The park, located in Pudong, Shanghai, is about a two-hour flight from Wuhan.

The U.S. State Department says China itself remains on travel advisory Level 2, Exercise Increased Caution, because of arbitrary detentions and law enforcement concerns, including the so-called exit bans where U.S. citizens are prevented from leaving the country, often for the government to gain leverage over relatives that it is after.

A senior State Department official said the U.S. had seen “positive signs” in China’s response to stem the coronavirus outbreak in Wuhan, but added that China has lacked transparency in the past and has shown it can be more preoccupied with saving face publicly than admitting and treating the problem.

“We’re concerned, but cautiously optimistic,” the official said.

The Walt Disney Co. is the parent company of ABC News.


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tulcarion/iStock(NEW YORK) -- What started off as a viral infection only in China in December is now spreading throughout Asia and has made its way to the United States. The novel coronavirus -- "2019-nCoV"-- in the same class as the SARS and MARS viruses, is now linked to the death of at least 26 people and has infected hundreds more worldwide as it continues to spread.

Transportation has been shut down in Wuhan, China, and neighboring cities. Five major U.S. airports have started mandatory screenings for direct and indirect flights from Wuhan including John F. Kennedy in New York, Los Angeles International Airport, San Francisco International, Hartsfield-Jackson in Atlanta and Chicago O’Hare International Airport.

With the recent outbreak, images from across the world show people wearing masks to ward off illness when traveling. However, wearing a mask is not a practice the Centers for Disease Control and Prevention recommends for preventing infection in healthy travelers.

There is little benefit to wearing a surgical type mask, and may even put you at greater risk for spreading infection, infectious disease doctors told ABC News.

"There isn’t a lot of data to support if there is any benefit to wearing a mask in the public setting. It is currently unclear," advised Dr. Jonathan Grein, a board-certified infectious disease physician and director of Hospital Epidemiology at Cedars-Sinai Medical Center in Los Angeles. He says masks are used by doctors and nurses when dealing directly with sick people. "We use them in the health care setting for two main reasons: to contain secretions of individuals who have respiratory infections and to protect healthcare workers providing direct care to patients."

If a patient starts to develop symptoms, a surgical mask has been shown to limit spreading germs, which is not only polite but could help limit a dangerous outbreak.

"Many respiratory viruses are spread by large respiratory droplets which are filtered by surgical masks," said Dr. Jennifer Wu, assistant professor of infectious disease at the Emory University School of Medicine and former medical epidemiologist at the CDC. "If someone has a cold or the flu or another viral respiratory infection, wearing a simple mask will decrease the risk of that person spreading infection."

Health care professionals and those in direct contact with the sick are advised to wear N95 medical respirator masks. These masks are rated for higher protection.

"Industrial masks [for example, ones worn for construction] or other occupational respirators are not designed for healthcare use or infection control. Medical N95 respirators are only recommended for health care personnel that are fit-tested and trained in their use," says Dr. Wu.

"With N95 respirators, if you wear them properly, the work of breathing is very difficult and should not be worn for a long time," said Dr. William Schaffner, professor of preventive medicine and infectious disease at Vanderbilt School of Medicine and medical director of National Foundation of Medical Diseases. "Painter’s masks are very flimsy and aren’t any good for preventing someone from respiratory infection. The CDC is very skeptical for these reasons."

But what about passengers on trains and planes trying to avoid getting sick during cold and flu season or during an outbreak like the coronavirus?

"Masks are not recommended for general protection if you are not ill," said Wu.

There may even be a risk to wearing a mask preventively.

"The mask itself can become contaminated and serve as a source of infection actually doing more harm than good," said Grein. "If wearing a mask, I caution touching it."

Instead, he advises, "avoid travel if you are ill, sneeze or cough into your sleeve and not your hand, and always washing your hands frequently."

"It’s also very important to get the flu shot," he said to protect yourself and those around you.

The CDC recommends following its current guidelines for safe travel during the coronavirus outbreak which include:

  • Avoid contact with sick people.
  • Avoid animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat).
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
  • Older travelers and those with underlying health issues may be at risk for more severe disease and should discuss travel to Wuhan with their healthcare provider.
  • Medical personnel in the hospital taking care of sick patients should use contact precautions and wear an N95 disposable face piece respirator.

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Darwin Brandis/iStock(WASHINGTON) -- A coalition of health insurers pledged $55 million to help manufacture generic prescription drugs at lower prices, as the skyrocketing cost of medication has triggered a national reckoning.

The Blue Cross Blue Shield Association and 18 independently operated Blue Cross Blue Shield companies announced Thursday they were partnering with the nonprofit generic drug manufacturer Civica Rx to create a subsidiary dedicated to "lowering the cost of select generic drugs," according to a joint statement.

The new subsidiary is being formed "in response to the impact of high drug costs on the health of Americans and the overall affordability of health care," the statement added.

Their first batch of generic medicines should become available by early 2022.

The move comes at a time when the pharmaceutical industry and lawmakers have faced immense pressure to lower the cost of prescription drugs. In 2019, a record 51 laws in 33 states were enacted to address drug prices and access. As the 2020 presidential campaigns ramp up, health care costs remains a key issue for voters.

"We believe everyone should have access to health care, no matter who they are or where they live," Scott P. Serota, president and CEO of BCBSA, said in a statement.

He added that he hopes "others will join us to achieve the change Americans want to see in the health care system."

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wellesenterprises/iStock(WASHINGTON) -- Now: There are 616 confirmed cases of the new coronavirus in China, and 17 people have died from it.

The majority of the sickened patients are in China, with Japan, Thailand, South Korea, Taiwan, Vietnam and the United States all confirming exported coronavirus cases.

College student quarantined in Texas


Health authorities in Texas are investigating a suspected coronavirus case in a Texas A&M student, according to the local health department.

The student, who recently traveled to Wuhan, went to an emergency department yesterday with a cough and congestion.

"The patient we're tracking had very mild symptoms," Dr. Eric Wilke, of the Brazos County Health Department, said at a Thursday news conference.

The patient is in isolation at home as health care workers are performing tests to determine whether the student contracted the coronavirus. Wilke said the department expects to have results back from the CDC in Atlanta by Monday at the latest.

Should the case be confirmed, health officials will begin contact tracing to determine with which individuals he came in contact and whether to monitor them.

Wilke did not say whether the student lived on campus.

China's expands travel ban

China extended its severe travel ban to additional cities, cutting off travel for 20 million people during a time when millions are expected to be traveling for Chinese New Year.

The quarantine began Thursday in Wuhan, the city at the center of the coronavirus outbreak. Authorities shut down transportation in the 11-million-person city, prohibiting people from using buses, trains or ferries, and canceling flights and trains leaving Wuhan.

Those travel restrictions have been extended to the nearby cities of Huanggang and Ezhou, both in China's Hubei province.

WHO decides not to declare an emergency

After two days of deliberation, the World Health Organization decided not to declare the coronavirus outbreak a "public health emergency of international concern" on Thursday.

"Make no mistake. This is still an emergency in China," Tedros Adhanom Ghebreyesus, director general at WHO, said at a news conference after Thursday's meeting. "It has not yet become a global health emergency. It may yet become one."

Part of that decision hinged on the fact there's been no evidence of human-to-human transmission outside of China so far. Additionally, disease transmission appears to be limited to close family groups and health care workers, according to the WHO.

Coronavirus concerns has airport in Los Angeles on high alert

A traveler who arrived at Los Angeles International Airport from Mexico City on Wednesday night was transported to a hospital for medical evaluation after he showed signs of being sick. American Airlines confirmed that the patient had flown with with the airline and that the person was being evaluated at a local medical center for "precautionary reasons."

While the airline is coordinating with the CDC, it's not yet known what the patient's symptoms were or whether they traveled to Wuhan.

Surveillance at airports has intensifies around the country, with airports in New York, San Francisco, Los Angeles, Atlanta and Chicago all screening travelers from Wuhan.

Doctors are treating the coronavirus patient in Seattle in a bio-containment room


The first patient in the United States to contract the new coronavirus is a man in his 30s from Washington state who traveled to Wuhan but said he didn't visit the seafood and live-animal market where the virus likely originated.

Doctors in a medical center near Seattle are treating the patient in a 20-by-20 bio-contaminant room. Doctors are using a robot with stethoscope to care for the patient, while limiting their contact with the virus. Four specially trained nurses in hazmat suits and security guards are on watch around the clock.

Only a handful of health care workers have entered the room to treat the patient, who is doing well, according to doctors at the medical center.

The patient's care includes extra fluids and Tylenol for his fever and cough, symptoms he probably could manage at home if he hadn't been diagnosed with coronavirus.

What people who died of coronavirus had in common


China's health commission released details about the 17 people who have died so far in the outbreak, the majority of whom have been men, older people or those with underlying health problems.

Those findings mirrored what officials from the World Health Organization described during a Wednesday news conference. Many of the people with severe forms of the new coronavirus were men older than 40 who had existing health issues.

WHO officials were quick to note that this demographic information doesn't mean younger people aren't affected by the new coronavirus. Instead, it's likely that the disease affects older people more severely, which was also true in the SARS outbreak.

Scientists have competing theories about the animal behind the outbreak


Coronavirsus, a family of viruses that include SARS, MERS and the common cold, can jump from animal to human hosts.

Scientists have competing theories about the animal source behind the virus. In addition to bats, which scientists have speculated about since the beginning of the outbreak, and which were implicated in the SARS outbreak, a group of researchers published paper this week, theorizing that snakes are the most likely reservoir behind the outbreak. Neither theory has been confirmed.

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Jonathan Wiggs/The Boston Globe via Getty Images(BOSTON) -- John Kapoor, the billionaire founder and former chairman of Insys Therapeutics Inc., was sentenced to five-and-a-half years in prison and ordered to pay a $250,000 fine for his role in a fraud and bribery scheme that contributed to the nationwide opioid crisis in the United States.

Kapoor, 76, is one of the highest-ranking pharmaceutical executives to face trial and prison time amid the U.S.'s opioid epidemic.

In May 2019, a federal jury in Boston found Kapoor guilty of federal racketeering conspiracy charges for his role in an elaborate nationwide scheme to bribe doctors to prescribe the company’s highly addictive opioid medication SUBSYS. Federal prosecutors also claimed that the scheme defrauded insurance companies into paying for the drug.

“Dr. Kapoor is disappointed in the verdict, as are we,” defense attorney Beth Wilkinson said after the verdict, according to Bloomberg. “Four weeks of jury deliberations confirm that this was far from an open-and-shut case.”

Kapoor’s four co-defendants, all of whom are former Insys executives, were also found guilty of racketeering conspiracy for their roles in the scheme.

A federal criminal indictment and hundreds of lawsuits accused them of coaxing doctors with money and sexual favors to prescribe SUBSYS -- a U..S. Food and Drug Administration-approved fentanyl spray specifically for severe cancer pain -- to thousands of patients who did not have cancer. Then, according to prosecutors, Insys "put profits over people," defrauding insurance companies to have them pay for it.

Former Insys vice president of managed markets Michael Gurry was sentenced last week to 33 months in prison and three years of supervised release and ordered to forfeit $3.6 million -- much less than the 11 years in prison that prosecutors sought.

"From May 2012 to December 2015, Gurry and his co-defendants conspired to bribe practitioners, many of whom operated pain clinics, in order to induce them to prescribe Insys’ fentanyl-based pain medication, Subsys, to patients, often when medically unnecessary," the government said in a press release announcing Gurry's sentencing.

The company’s former CEO Michael Babich pleaded guilty in federal court in January 2019 to conspiracy and mail fraud charges after striking a plea deal with prosecutors. Former vice president of sales Alec Burlakoff also struck a deal with prosecutors and pleaded guilty in federal court to racketeering conspiracy.

One of the people who attended Kapoor's sentencing in Boston was decorated war veteran Jeffrey Buchalter.

Buchalter was hit with multiple improvised explosive devices (IEDs) over the course of three combat tours in Iraq -- the worst of which left him with nearly a broken back. But he survived.

And yet, he said he found himself closest to death back home while under the care of a doctor who prescribed him SUBSYS.

“I missed some of the best years of my kids' life,” Buchalter told “Nightline” in an interview last year, referring to the years he says the powerful fentanyl spray consumed his life. “I can't get that back.”

Buchalter, along with Patty Nixon, a former employee of Insys, and Richard Hollawell, a small-town attorney on a crusade against the company, have found a common cause in attempting to hold Insys responsible for what they say is its role in the opioid crisis.

According to the Centers for Disease Control and Prevention (CDC), there were 47,000 opioid deaths reported in 2017 and more than a third of those were caused by prescription medications. Yet, no pharmaceutical executive has ever been convicted in a criminal case until now.

More than 7,000 deaths have been reported of people who were taking SUBSYS -- all of whom were patients who didn’t have cancer but were prescribed the drug anyway -- according to the FDA's Adverse Events Reporting System. Fentanyl is up to 50 times more powerful than heroin, according to the CDC.

“Makes you wonder why they're not charged with homicide,” Buchalter said.

During his military service, Buchalter said he was exposed to 14 IED blasts that left him with significant spinal injuries. He ended up at Walter Reed National Military Medical Center in Bethesda, Maryland.

“The vertebrae had slipped off each other,” he said. “And the back was actually in jeopardy of sliding off and causing paralysis, if not worse.”

Still, Buchalter flourished. He got married and he and his wife settled down in Maryland and started a family. Being a dad meant “everything” to him, he said.

“It's the strength that you need when you don't feel like there's anything else that'll give you the motivation to be the better version of yourself,” Buchalter said.

But he said there were moments when the pain from his spinal injuries was unbearable. He was prescribed Percocet, oxycodone and a host of other prescription painkillers.

“I don't think there's one I haven't been on,” he said, acknowledging that he became addicted to opiates.

“I would say that I was taking more than I ever should have,” he added.

Buchalter said a simple fall, an injury or sleeping in a bad position would cause his back to flare up.

“At that point, [the pain was] a 10 out of 10,” Buchalter said. “It would be ungodly. I couldn't move, had difficulty walking and when that would happen, I'd always have to go to the emergency room to get treated for acute pain.”

In 2010, Buchalter thought he had found a better approach when he was introduced to a new doctor: Dr. William Tham, a pain specialist in Annapolis, Maryland.

According to Buchalter, Tham told him, "There's this new medication that I think will keep you out of the emergency room." That medication was SUBSYS, which patients spray and hold under their tongue for up to a minute.

SUBSYS was FDA-approved specifically for severe cancer pain. But Buchalter and thousands of other patients like him were prescribed the drug “off-label,” meaning that the medication is being used in a manner not specified on the FDA-approved packaging label for the drug, according to the FDA. It’s a legal and common practice for many prescription medications but tightly regulated for powerful opiates.

“This is a very narrow drug,” attorney Richard Hollawell told “Nightline” last year. “This is approved for one reason only…and that's breakthrough cancer pain.”

But it didn’t matter if patients had cancer pain, Patty Nixon, a former Insys employee told “Nightline” last year. Nixon’s role at Insys, she said, was getting insurance companies to sign off on payments for SUBSYS prescriptions. It was one part of the alleged years-long scheme that cheated millions of dollars from insurers, including Medicare. According to Nixon, only around 10% of patients for whom she helped to get prior authorization for insurance payments actually had cancer.

What mattered, Nixon said, was for patients to be insured so that Insys employees could make sure those SUBSYS prescriptions were paid for.

Nixon claimed that her employer was “asking me to lie to insurance companies about patients having cancer and breakthrough cancer pain.”

“I was in a very small office in Chandler, Arizona, and I would call Alaska and say I was from Alaska… Sometimes I was from Hawaii,” Nixon said. “Wherever the patient was from and wherever the doctor was located.”

Nixon said the lies were all based on a script that she would read over the phone, which Insys executives instructed her to follow when speaking to insurance companies. They called it “The spiel.”

“A lot of it was word games,” she continued. “When the insurance company would ask the question… ‘Does the patient have cancer with breakthrough cancer pain?’ And when we would respond, we would say, ‘Yes, we're treating the breakthrough pain.’ … So it's eliminating the word cancer.”

The National Cancer Institute describes breakthrough cancer pain as when a cancer patient, who may already experience chronic pain, has a sudden increase in pain or a severe flare-up.

One day, Nixon said she “had a particular chart with an insurance company that I was having difficulty getting approved,” so she went to her boss.

“And she grabbed a sticky note and she wrote down 787.20 and she handed it to me and said, ‘That's for difficulty swallowing. Put that on every single chart and you won't have any problems,’” Nixon said, even if it wasn’t true.

Nixon said she started learning about the patient deaths through her own research.

“I found that people had passed away. Sarah Fuller is a patient that had passed away,” Nixon said. “I feel like if I would have spoken up sooner then maybe I could have saved her life. I'm sorry.”

“I don't think people really understand what it's like to live with this,” she continued. “It's not easy to sit here and have this interview with you. But I still have my voice and they don't.”

Sarah Fuller was a 32-year-old New Jersey woman who had been battling chronic pain after a series of car accidents. When treatments left her struggling with opioid addiction, she turned to New Jersey family physician Dr. Vivienne Matalon.

Fuller’s mother, Deborah Fuller, told “Nightline” last year that she said to Matalon, “Sarah is addicted to painkillers. So when you deal with her chronic pain, you gotta find another avenue, like maybe yoga or something like that, or physical therapy. Something that isn't drugs.”

But Deborah Fuller said Matalon disregarded the family’s plea. During a January 2015 appointment, Sarah Fuller was prescribed SUBSYS -- an appointment that Fuller said was accompanied by an Insys sales rep.

The following day, according to court documents, that Insys sales rep texted her manager about how to get Matalon into the Insys speakers program, which federal prosecutors allege was a bribe to get doctors to prescribe SUBSYS.

Federal prosecutors allege that Insys began the speakers program to increase brand awareness due to its dissatisfaction with sales after only three months on the market.

These programs, hosted by pharmaceutical companies, are legal and are commonly held to teach doctors about new medications. But in the case of Insys, prosecutors argue that the company conceived its program as a front for bribes.

“One of the things that they do is they identify medical providers [and] physicians that are high prescribers of opioids in general. Pain-management doctors, not oncologists,” Hollawell said.

Tham, the pain specialist who treated Buchalter, was allegedly part of Insys’ speaker series. He received at least $55,000 from Insys between 2013 and 2016, according to the Centers for Medicare and Medicaid Services’ (CMS) Open Payments database. Open Payments is CMS’ national transparency program that collects and publishes information about financial relationships between the health care industry (drug companies) and health care providers (doctors, hospitals).

“They [Insys] were setting up sham speaking events,” Hollawell said. “It was just a means to have a fancy dinner and act like that they were putting on an educational event that was legitimate.”

A 2016 complaint filed by states attorneys general on behalf of 24 states said Insys promised one physician a $100,000 payment for his “support with Subsys” and that “Insys spent $58,000 on meal expenses for doctors in just one month.”

Those meals were often accompanied by sales reps like Amanda Corey Emhof, a former reality show participant who had appeared on TV’s “Beauty and the Geek” and one episode of “Judge Judy,” as well as modeled for Playboy.

In a statement to ABC News this week, Emhof said: “I really just wanted to defend my character as I was portrayed as someone that Insys only hired because I was a former model and allegedly unqualified for the position. The truth is I was on a reality show in 2008 on a family-friendly network, CW (“Beauty and the Geek”), and modeled for the iconic magazine Playboy in 2011. What the story failed to mention is I also hold a B.A. degree from the University of Arizona, a substitute teaching credential for grades K-8 and was the owner and operator of a modeling/talent agency from 2009-2018. All of this information was discussed during my interview with Insys. My former modeling career during my interview was never mentioned. I feel I was used as a scapegoat in order to gain momentum for your story as nothing about what made me qualified for the sales position was mentioned.”

Evidence shows Insys routinely employed sex appeal to drive prescriptions, according to prosecutors.

"I have never seen such in-your-face, such egregious, blatant behavior... Hiring drug reps that had no industry experience whatsoever. Strippers. Just people that didn't have college degrees, had no understanding of the FDA and regulations," Hollawell said.

Sunrise Lee, who worked for Insys as a regional sales manager, was accused of giving a doctor a lap dance in a Chicago nightclub in 2012, according to witness testimony.

“She never worked in the pharmaceutical industry,” Hollawell said. “And they're bringing somebody in that was an exotic dancer and ran an escort service to sell a product that could kill somebody with one prescription. And that was their M.O.”

Lee has denied the allegations, stating through an attorney that the witness “admitted to being intoxicated.”

Socializing with doctors was a corporate strategy. One 2012 email from Insys' then-vice president of sales Alec Burlakoff shows him pressuring his staff in one of his many directives, according to a report by the U.S. Homeland Security and Government Affairs Committee.

One line reads: “How do I transition from the doctor viewing me as ‘the Subsys representative’ to ‘Alec -- my friend in pharmaceuticals’?"

Another: "Have I really FORCED myself to step ‘outside’ of my comfort zone?"

And another: "If you have not found a way to spend time with your customers OUT OF THE OFFICE AND NOT IN A RESTAURANT it’s simply not good enough."

It seemed to work. Between 2012 and 2013, Insys saw more than 1,000% growth in net revenue of SUBSYS sales -- the best performing initial public offering of the year. The following year, SUBSYS became the most widely prescribed drug of its type.

By then, Insys CEO John Kapoor, a soft-spoken immigrant from India, had become a billionaire. By 2015, he was on Forbes’ annual “Richest People in America” list.

All the while, Kapoor was hailing his drug as a win for patients and shareholders alike. Speaking at the annual tech conference TiEcon in 2015, Kapoor told the audience, “That product [SUBSYS] that we launched three years ago will do close to $300 million.”

“All these changes create a product the patients want and in two to three years our market share is approaching 50% of the market,” Kapoor said in that same speech.

At an Insys national sales meeting in 2015, the company played a crude five-minute rap music video celebrating their success. The video showed Burlakoff in a fentanyl spray bottle costume while two young Insys salesmen danced in sunglasses and hoodies. Some of the lyrics included, "I got new patients and I got a lot of them" and “We’re raising the bar and we’re changing the game. To be great, it takes a decision to be better than the competition.”

Meanwhile, patients like Sarah Fuller and Buchalter were edging closer to death.

Hollawell, the Fuller family's attorney, said he got a subpoena for the recording of a phone call that an Insys employee made to Fuller's insurance company pretending to be from Matalon's office.

“That’s [what] I would call... the murder weapon, the smoking gun, all those terms,” Hollawell said. “If they did not make that call, she would've never been approved for the drug, and you heard all the misrepresentations that were made.”

In the recording, the Insys rep is heard telling the insurance rep that the doctor was treating Fuller “for breakthrough cancer pain.”

"Let me look here... Medication intended for the management of breakthrough cancer pain," the Insys rep said, misrepresenting Fuller's diagnosis.

A carton of SUBSYS was eventually delivered monthly to Sarah Fuller’s door. Over time, her mother said, Sarah became “extremely lethargic. Her complexion, pale.”

“It was literally killing her,” Deborah Fuller said.

Sarah Fuller died nearly 15 months after starting on SUBSYS. At the time she had been planning her wedding, but she never made it to her wedding day.

“[On] her wedding day we all met here [at Sarah’s grave site], her fiance, us, and everybody left something,” Deborah Fuller said. “My daughter and I brought wedding balloons. My husband brought a wedding topper and two champagne flutes. Her fiance left a bouquet of flowers.

“And it was just really surreal because we should be in a church watching her walk down the aisle and go to a great reception. But that's not how it happened,” she continued.

The Fuller family sued Insys and Matalon for negligence and wrongful death.

In May 2018, the New Jersey Board of Medical Examiners revoked Matalon’s license. The Fuller family and Matalon, who claimed she was misled by sales reps about using SUBSYS to treat Sarah Fuller, reached a settlement for an undisclosed sum without admission of wrongdoing.

In a statement to ABC News last year, Insys declined to comment on ongoing litigation, but said that it “in no way defends the past misconduct of former employees and is fully cooperating with the government. … Last year, Insys further announced its intention to divest its opioid business and focus its efforts on non-opioid drugs."

The company would only acknowledge in its statement that, "as of Jan. 1, 2019, there have been 951 cases of patients who passed away while on, or having been suspected to have been on SUBSYS. The majority of those cases were assessed as not related to the use of SUBSYS, or having insufficient information to make a causal assessment. As SUBSYS is approved for the treatment of breakthrough cancer pain, to say these deaths are ‘associated with the use of SUBSYS’ is both inaccurate and misleading.”

Nixon told “Nightline” last year that she remains consumed by guilt and regret for her role in exposing SUBSYS to countless patients. She testified before a grand jury that indicted Babich.

“It was scary. I mean, I had to tell the truth, I had to tell what my job was and what I did. And what I did was illegal. So that was really scary. I wasn't sure what was gonna happen to me,” Nixon said. “I didn't ask for any plea deal... I'm not trying to profit from this in any way, shape or form.”

As for Buchalter, he told "Nightline" last year that his life was wrecked by SUBSYS. He said he had a so-called “come to Jesus moment” when he ended up in the emergency room, again in severe pain and with sterile abscesses in both legs. He said the ER staff “refused” to give him the dosage of pain medication that he’d told them he’d been prescribed.

“The nurses were scared to death to give me those doses,” he added.

By that point, Buchalter said he was taking so much of the fentanyl-based SUBSYS spray that it was equal to 5,000 Percocet a day or “a gram of heroin.”

“Somehow my body recognized it as something that it needed and…that's the difficult part of going forward is nobody really understands why I survived,” he said.

The hospital was so alarmed, Buchalter said, that its staff admitted him into the intensive care unit to bring him off the fentanyl.

Since that near-death hospital visit, Buchalter said he has spent years working to rebuild his life sober. The withdrawals felt like “hell on earth,” he said. Ultimately, his house went into foreclosure, he and his wife divorced and he moved into a transitional shelter for homeless veterans.

“My biggest regret is my children having to suffer the anguish of seeing their daddy in and out of hospitals and struggling to regain his health,” Buchalter said.

He filed a lawsuit against Insys and and his former doctor, Tham.

Tham denies any wrongdoing. In response to the allegations made by Buchalter, both Kapoor and Tham’s attorneys told ABC News last year they had “no comment.”

Buchalter said he has asked himself, “why I survived when I shouldn't have.”

“I believe I survived to tell the stories of those that didn't,” Buchalter told "Nightline" in an interview last year. “I owe it to myself to my family and all the others who didn't, to get my story out and to get back to the top of the mountain, so to speak.”

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Jesse Thorson(MEDFORD, Ore.) -- A mother of four who died suddenly, just days after giving birth, donated 12 organs that could help save a dozen lives.

On Dec. 29, Kathleen and Jesse Thorson of Medford, Oregon, welcomed their fourth child, a boy named Teddy.

On Jan. 3, Kathleen was rushed to the hospital after suffering intracerebral hemorrhage, or bleeding inside her brain. Her husband said she appeared otherwise healthy and that the cause was unknown.

Doctors performed a craniotomy, a surgical operation to the skull, but Kathleen died a few days later. She was 34.

Although Kathleen's family is grieving, her husband told "Good Morning America" that the organ donation provided a moment of positivity amid the tragedy.

"I'm glad my kids will know their mom for doing that," said Thorson, who's dad to Danny, 7, Gracie, 6, James, 4 and Teddy, 3 weeks. "My 7-year-old told his third grade class that his mom has 'helped people.'"

"As we get to know more about that process ... recipients who receive [Kathleen's] organs, it's something that will be continually lifting us," Thorson told "GMA."

He shared the story of how he and Kathleen met -- on the first day of high school.

"I was a junior. I put my foot in my mouth, and we've been together ever since," Thorson recalled.

"We never spent a minute apart," he added. "We had 14 years and used every minute of it ... there are no regrets of how we spent the time, just about the amount of time we had."

Kathleen held a bachelor's degree from Brigham Young University-Idaho, and both she and Thorson completed their graduate studies together abroad at University of Kent in Canterbury, England.

The couple married Sept. 1, 2006.

"When our son Danny was born [two weeks premature], she asked if it was OK if she was 'just a mom.' I said, 'Absolutely.' That's when I decided to become to a nurse. She wanted to be at home with her kids. That was her chosen career," he recalled.

Thorson said Kathleen loved being outside, taking walks enjoying nature. She also loved to bake pies.

As a person, Kathleen was very accepting of everyone around her, Thorson added.

"I don't know if she ever met someone she couldn't find a way to love and care about," he explained. "Her heart was wide open. ... Her heart and her kindness and her willingness to love, I'm making sure that's in every crack of my home and learning how to do all the things that she did while I was at work."

On Jan. 8, family friend Richard Stubbs launched a GoFundMe page in honor of Kathleen. Over $120,000 was raised to help cover medical bills and funeral costs.

Stubbs told "GMA" that he and his wife, Janae, truly loved Kathleen and that they will be with Thorson and the kids "for the long haul."

"Jesse has amazed us again and again," Stubbs said. "He has remained calm despite his crushing grief, and he has been able to respect the wishes that Kathleen shared with him long before tragedy struck, that should anything happen to her, her organs should be donated to save others."

Thorson said the overwhelming amount of emotional support speaks volumes to how much Kathleen was adored.

"I feel like my wife collected an army of people similar to her, with very giving spirits, and that has been evident in the last couple of weeks," he said.

Nearly 114,000 people in the U.S. are currently on the waiting list for a lifesaving organ transplant, according to the American Transplant Foundation -- and a new name is added to the national transplant waiting list every 10 minutes.

Thorson said Kathleen always knew she was an organ donor. Kathleen's parents and sister were also on board with her decision. Thorson said he's looking forward to learning more about the recipients of his wife's organs.

"It's an education I've never wanted," he added, "but it's something we're all proud of her for."

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nazdravie/iStock(DENVER) -- A woman who shared a photo of her negative pregnancy test is inspiring others to keep fighting as they try for the baby they've always wanted.

Tara Engelberg, 33, a "mama in waiting" from Denver, Colo., has often shared her infertility journey with over 2,000 followers.

But it was her post on Jan. 13 that hit home for thousands more after being shared by the lifestyle brand, Motherly.

"It's OK to cry, to be afraid, pray, hope and believe in miracles," Engelberg told Good Morning America. "Your feelings and emotions are so valid and there's so many women and men going through this."

"We're not alone," she added. "Together we're stronger. I held in my journey for two years. My husband and I didn't tell a soul, but I couldn't keep it in anymore because it's such a lonely place to be."

Last week, Engelberg snapped a photo of her home pregnancy test which revealed one line. She wrote on the stick, "It will be OK" before posting it on Instagram.

"I sometimes wish there was a video camera to show the nightmare that is #infertility," Engelberg captioned. "How after the first sighting of a new period that I somehow have to muster up the courage to tell my husband that once again, we won't be pregnant this month."

She went on, "It's a scene all too familiar in my home. It is a scene that is followed by grief and utter heartbreak. Where my husband and I hold each other close as we mourn this unbearable journey. It is the part where we allow ourselves to release our pain and then try to figure out how we are going to pick ourselves back up and get through this ...

"After each negative pregnancy test, I somehow gather the courage and the hope to try again. But after nearly 1200 days of trying, something inside changes. That hope that use to flow through my body so powerfully diminishes a little more each month."

Engelberg, an aspiring holistic nutritionist, married Glenn Engelberg in 2016. The couple has been trying to conceive for over three years, she told GMA.

Earlier in 2019, Engelberg underwent surgery to correct endometriosis. She was told she would never be able to have children naturally, she said.

Engelberg shared that journey and the pregnancy test on Instagram to let others know this is "real life."

Infertility is defined as the inability to become pregnant after one year of having regular sexual intercourse without the use of birth control, according to the American College of Obstetricians and Gynecologists. The time span is shortened to six months without becoming pregnant for women age 35 and older.

Over 6 million women in America struggle with infertility, according to the U.S. Department of Health and Human Services.

Thousands of women from around the world commented on the photo of Engelberg's pregnancy test -- many of whom shared stories of their own fertility struggles.

"It took us 7 years of negative pregnancy tests and 1 positive test that ended in a miscarriage," one woman wrote.

"I struggled getting pregnant for years and finally got pregnant with out little boy that we are welcoming into the world in May," another shared.

Many commenters offered encouraging words: "It’s worth it, I promise! Keep fighting."

Engelberg said she appreciates the sisterhood on social media.

"I was in such a bad place, I literally didn't know how I'd continue on and I've been shown [so much] love and support...what a beautiful thing to have women supporting women regardless of race and religion to show the more we stick together, we can get through it."

For the next five months, the Engelbergs are turning to holistic alternatives. If it's unsuccessful, they will begin IVF.

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