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CDC

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By Daniel Dunaief

In a nod to the herd immunity from a combination of illnesses and vaccinations in the population, the Centers for Disease Control and Prevention is widely expected to reduce the recommended number of days of isolation after a positive test to one day from five days.

Even as most of the population has returned to a normal life after the pandemic — toughing through colds with relatively mild symptoms at work and staying home, for the most part, when symptoms become severe — the CDC had urged Americans to remain isolated for five days.

“Covid has diminished as a real threat for the majority of people,” said Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “The responsiveness between vaccinations and multiple events [such as infections] is reasonable to prevent hospitalization and death in most people.”

In addition, Covid treatments, such as Pfizer’s Paxlovid, have become effective in reducing the severity and duration of symptoms.

The CDC likely couldn’t have provided such guidance a year ago, but, for most people, the consequence of contracting the virus that altered the course of life for people for several years, has been less problematic for their health, doctors said.

Despite ongoing illnesses and symptoms, people have become less likely to test for Covid.

“Insurance companies used to pay for eight per month, but now, people just buy one [test box] at a time,” said Michael DeAngelis, the owner of Village Chemist in Setauket.

Dr. Sunil Dhuper, chief medical officer at Port Jefferson’s St. Charles Hospital, understood the CDC’s decision, with an important warning.

“The rationale behind changing the timing of isolation guidelines is based on looking at the evolving severity of cases,” Dhuper said.

“People who are younger get more mild levels of illness and recover,” he added.

Concerns for the elderly

“The disease is beginning to behave more and more like other respiratory viruses, but we are not there yet,” Dr. Dhuper cautioned, particularly for those who are over 65.

Hospitalization for people who contract Covid is 11.2 per 100,000 for people over 65, compared with 6.9 per 100,000 in the week ending Feb. 10, according to data from the Centers for Disease Control and Prevention. 

The mortality for those over 65 from Covid is higher than for the flu, Dr. Dhuper said.

“We have to be a little cautious, sending a message to the community that you can continue to do what you want to do,” Dr. Dhuper said. “When they are around the elderly” people, particularly those who might have symptoms even if they haven’t been tested, should consider wearing masks or keeping their distance.

The incidence of Covid, among other illnesses, climbed after the December holidays and the start of 2024, as people traveled to visit with family or on vacations. Those numbers have come down, although the upcoming spring break from secondary schools and colleges raises the possibility that illnesses could climb again, doctors predicted.

Be careful of grandkids

While the public may not want to hear it, Dr. Dhuper expected that it might take another five years before Covid reaches a comparable level of potential risk to the elderly as the flu, which could also present a risk to people’s health.

Dr. Dhuper urged those who have symptoms to test themselves for Covid. Even if they don’t isolate themselves for more than 24 hours, they should be cautious around vulnerable groups.

Dr. Dhuper’s advice to grandparents is to “be careful when you’re around your grandkids, because they are like petri dishes, harboring tons of infections.”

While for many people in the community, Covid has become like white noise, it’s still causing medical problems and leading to some hospitalizations, the St. Charles doctor added.

Any change in isolation guidance from the CDC should come with an asterisk that “yes, we are changing the guidelines, but people should still exercise precautions,” Dr. Dhuper said.

Vaccination research

Amid discussions related to vaccines, Dr. Nachman added that several compelling papers have demonstrated that people who are up to date on their vaccines, including flu, are at lower risk for dementia.

The link between vaccinations and overall brain health is unclear, and it is possible that people who receive vaccines also have a lifestyle that reduces the risk of developing dementia.

“We have an aging population in New York, particularly on Long Island,” said Dr. Nachmman. “If we want to keep them healthier longer, getting appropriate medical care, including vaccines, is probably helpful.”

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The spread of the new coronavirus has become increasingly likely in the United States, public health officials suggested, as the sickness that started in China has infected people in 39 countries including Italy and South Korea where an American service member has contracted the virus.

During a conference call with reporters on Tuesday, Nancy Messonnier, the director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, said it was “not a question of if this will happen but when this will happen and how many people in this country will have severe illnesses.”

Messonnier’s warning included a suggestion that people start asking their schools about plans for dismissal and for conducting classes online if the coronavirus, now called Covid-19, affects their communities.

Stocks fell sharply lower on Monday and Tuesday amid concerns about the effect on the global economy.

As of earlier this week, over 80,000 people had tested positive for Covid-19, which claimed the lives of over 2,700 people. In the United States, the number of confirmed cases, including those from the Diamond Princess cruise ship, had reached 57. None of those cases is in New York, where 26 tests have come back negative and one is still pending, according to the New York State Department of Health.

Bettina Fries, the chief of the Division of Infectious Diseases in the Department of Medicine at the Renaissance School of Medicine at Stony Brook University, said the infections in Italy and South Korea signaled a new phase in the epidemic.

“We are now having these new cases where we can’t even link them” to exposure to people who have traveled to China, Fries said. “The genie is out of the bottle. Once that happens, it’ll be that much harder” to contain the virus.

Fries described the virus, which health officials believe is transmitted through droplets from people carrying the infection, as “behaving much more like the flu,” which is why the CDC is preparing for cases in the United States.

With other coronaviruses, including severe acute respiratory syndrome and Middle East respiratory syndrome, the majority of patients who transmitted these diseases had symptoms like high fevers. That may not be the case with Covid-19, as patients that are “asymptomatic could be shedding the virus,” making it more difficult to contain, Fries said.

Medical professionals don’t have any medication or vaccine, while the world population, which hasn’t been exposed to this new virus, also hasn’t developed any kind of resistance.

If pockets of the outbreak appear in the United States, it is “conceivable that schools could shut down and that there could be rules where people self quarantine” for the required 14 days, Fries said.

Fries added that it’s important to protect health care providers who are on the front lines in this battle. Stony Brook is continuing to make contingency plans in the event of confirmed cases of this coronavirus, which includes making space available if necessary. In the event of an outbreak, the hospital would change its policy of having trainees, residents and medical students go in and out of rooms with doctors on rounds, she said.

Fries added that the warmer weather may not cause a reduction in the incidence of the virus. “Every virus is different,” Fries said.

On Wednesday afternoon, Gov. Andrew Cuomo (D) announced several measures to prepare New York for the potential spread of the new coronavirus, called Covid-19, to the Empire State. Cuomo announced a $40 million appropriation for the New York State Department of Health to hire additional staff, procure equipment and any other resources necessary to respond to the spread of Covid-19. The governor is also proposing legislation to grant authority to the Department of Health Commissioner Howard Zucker to make sure local health departments and private and public hospitals take necessary actions in response to the virus. The department will bring together local health departments and hospitals statewide to review protocols, practices and procedures to make sure they are prepared to combat the spread of Covid-19.
Cuomo is also asking the federal government to authorize the Wadsworth Center and NYC Public Health Laboratory to test for the virus, which would speed up the test results. New York State has developed and validated a test using the protocol of the Centers for Disease Control. Once Wadsworth receives Food and Drug Administration approval, it can test people under investigation in New York and other northeastern states.
The Department of Health will coordinate with the Mass Transit Authority, Port Authority and airport operators and the workforces for these public transit systems to ensure workers are trained and can access supplies such as cleaning and protective equipment, that they need to operate mass transit and airports. New York is working with all state agencies to prepare for the potential pandemic.
Updated Feb. 28 to include information about Cuomo’s measures.

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Huntington Hospital is taking preventative steps to ensure its patients know how to combat the Zika virus.

The World Health Organization declared the Zika virus a “public health emergency of international concern” this week, just days after three Long Island patients tested positive for the virus. The Centers for Disease Control issued a travel alert for anyone going to regions including South America and Latin America, and Huntington Hospital officials said they were making sure to educate their patients about the symptoms and steps to take if diagnosed with the viral infection that is being spread through mosquitoes.

Denise Naval, director of infection, prevention and control at Huntington Hospital, said that while there is currently no treatment for the virus, there are several precautions a person can take to fight off the mosquito-related Zika.

Naval said the virus is closely related to Yellow Fever, the West Nile Virus and the Dengue virus, which are all also spread through mosquito bites. She said the Zika virus is spread from the Aedes mosquito, specifically.

There are two types of Aedes species, Aedes aegypti and Aedes albopictus, but only the former currently carries Zika with it and it is not native to Long Island, she said. It’s most common in tropical areas of the world. The latter does not currently carry the virus and is found in certain parts of the United States, including Long Island, she said.

Naval also said Zika can not only be transmitted from a mosquito to a human, but also vice versa — from a human to a mosquito.

“Only 20 percent of people will get symptoms,” Naval said in a phone interview. “Eighty percent of people infected won’t even know they are.”

According to the CDC, symptoms from the Zika virus include a fever, rash, joint pain, headaches and more.

Once infected, the CDC says patients must get rest, drink fluids to prevent dehydration, and take medicine such as acetaminophen to relieve fever and pain.

New York Gov. Andrew Cuomo recently announced that the New York State Department of Health, in conjunction with the CDC, would offer free blood test screenings for individuals who have traveled to areas where the Zika virus is going on.

“We’re working closely with the CDC and local health departments to address potential cases of Zika Virus, and by offering free testing we are helping to stay ahead of this disease and protect the public health,” Cuomo said in a press release.

Naval said if anyone must travel to the tropic regions, where Zika is a problem, there are some key precautions they can take.

“Make sure to use bug spray with DEET; stay indoors with air conditioning if you can because insects prefer heat; and wear long sleeves and long pants,” she said.

Aside from a warning for all travelers to avoid these tropic areas, there is also an extra precaution for pregnant women, as there is an added risk for a child whose mother has the Zika virus while pregnant.

The baby can be born with microcephaly, a neurodevelopmental disorder where a baby is born with a smaller head than usual, or other neurological and autoimmune complications, officials said.

According to the WHO, in countries like Brazil there has been an increasing body of evidence about the link between Zika virus and microcephaly. This specific brain disorder is linked to seizures, developmental delays in speech and walking, intellectual disabilities, feeding and vision problems, and more, according to the CDC.