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The exterior of Stony Brook Children's Hospital. Photo from Stony Brook Medicine

COVID-19, which was considered especially threatening to the elderly and those with underlying medical conditions, may also have triggered an inflammatory illness that is sickening children in several places throughout the world, including in Suffolk County.

An inflammatory illness in children with symptoms that mimic Kawasaki disease has sickened seven in Suffolk County and officials are expecting more cases of the rare condition here and throughout the country.

Stony Brook Pediatric Hospital has admitted two cases of the multi-inflammatory pediatric condition, for residents who are 10 and 19 years old.

With other hospitals showing rare but similar unusual pediatric cases, including in the United Kingdom and New York City, the U.S. Centers for Disease Control and Prevention is preparing to release an alert about the inflammatory condition, a CDC spokesman told CNN.

Symptoms of the new illness include an extended fever, a rash, red eyes, red lips, a strawberry tongue, lower blood pressure and abdominal symptoms like vomiting and diarrhea.

Stony Brook, Pediatric Hospital has been “treating patients like we would treat and approach Kawasaki Disease,” said Christy Beneri, the Fellowship Program Director in Pediatric Infectious Diseases at Stony Brook Children’s Hospital. The hospital has provided intravenous immunoglobulin, a high dose of aspirin and steroids to decrease inflammation and other medications to help suppress the inflammatory syndrome.

This rare inflammatory process in children has developed weeks after a likely mild or asymptomatic case of COVID-19 in mostly healthy younger patients.

Patients can develop symptoms from “days to weeks” after an infection with the virus that has caused the pandemic, Beneri said. The majority of people with this inflammatory reaction are either testing positive for COVID-19 when they come to the hospital or have a positive antibody test, which indicates their immune systems mounted a defense against the virus, Beneri added.

It is unclear to doctors what is causing the progression from a manageable response to the virus to an inflammation that may require a trip to the hospital and to the Intensive Care Unit.

“We are trying to understand how the coronavirus is causing vasculitis,” Beneri said. “It has something to do with how the virus is affecting blood vessels and organs.”

To be sure, Beneri reassured children and their parents that most of the children who are infected with Covid-19 will not develop these inflammatory symptoms later.

“The majority will do well,” Beneri said.

Nonetheless, Beneri anticipated that more pediatric residents in Suffolk County would likely show signs of this inflammatory response.

“If their child is having fever for a number of days, significant vomiting or diarrhea, belly pain, red eyes or a rash, it is important that they speak with their doctor,” Beneri said.

One of the reasons Suffolk County is seeing some cases of this Kawasaki-like response in children now, weeks after the pandemic infected thousands in the area, likely relates to the timing of the peak infections, which occurred in the middle of April.

Based on conversations Beneri has had with other pediatricians who are treating patients with similar symptoms, she said the patients tend to be “healthy kids” who have often had a contact with someone in their house who was recently diagnosed with COVID-19.

The child may have brought the virus into the home and passed it along to a parent, who became sick. The child, however, later develops these multiple-symptom inflammatory issues.

While some children have died from this condition, Beneri said the majority of them are recovering.

The duration of hospital stays has varied, with some patients requiring 10 days in the hospital, while others have recovered within a few days. Beneri said Stony Brook has already sent one patient home.

Beneri added Nassau County has also had several teenage patients come in with the same symptoms. She expects more Suffolk pediatric patients with similar symptoms to come to county hospitals.

Parents should be on the lookout, primarily, for persistent fevers over the course of several days with significant abdominal pain, Beneri said. “If they start developing other symptoms, such as red eyes and a rash and they are not getting better” then parents should contact their doctor or a hospital, Beneri advised.

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Stony Brook University's COVID-19 testing site. Photo by Matthew Niegocki

With 694 more people testing positive for the coronavirus, the number of confirmed cases in Suffolk County is now 40,483.

In the Suffolk County hotspot testing sites, the number of positive tests was 1,320 out of 3,412 total tests.

The percentage of positive tests at these hotspots is 38.7, compared with 33 percent for the county as a whole.

Antibody testing for law enforcement continues, with 1,581 law enforcement officers tested by Northwell Health and New York State so far.

The number of people who have died from complications related to coronavirus increased by 21 in the last day, bringing the total to 1,568 for Suffolk County. As of yesterday, the deaths from the virus exceed the number of people killed over 100 years ago aboard the Titanic. The staggering number represents what will likely be a turning point for the county, let alone the entire country which topped 77,000 deaths.

County Executive Steve Bellone’s (D) office distributed another 163,000 pieces of personal protective equipment yesterday, bringing the total number of such life-saving items to over four million since the crisis began in March.

Bellone didn’t have the closely watched hospitalization information today because the reporting system was down.

Separately, Bellone said the county was able to honor the 75th anniversary of the end of World War II in Europe.

“Today, we would normally be bringing together our veterans and particularly our World War II veterans to honor them and thank them for what they did for our nation,” said Bellone during his daily call with reporters.

A group including Suffolk County Chief of Police Stuart Cameron and Suffolk County Veterans Services Agency Director Thomas Ronayne raised an American flag above Armed Forces Plaza today. The group saluted the flag and then brought it to the state veteran’s home.

That home has been hit especially hard by the pandemic. As of May 5, the home reported 65 residents have passed away due to the coronavirus. Additionally, 68 residents have tested positive, where out of those four are receiving treatment at neighboring Stony Brook University Hospital. 30 of those veterans are in the post-COVID recovery phase.

Bellone said the county also celebrated the graduation of 70 members of the police academy. While the ceremony was different than it otherwise would have been prior to the pandemic, the event, which was broadcast on Facebook, was watched by more than 25,000 people.

“Their willingness to step forward at any given moment to risk their lives for strangers is an extraordinary thing,” Bellone said. “We thanked them and their family members.”

Separately, as for the national and local elections coming this November, Bellone said he hopes the bipartisan cooperation that has characterized the response in Suffolk County and New York will continue.

“I don’t know if we’re going to see that on a national level [but] at the local level, we are working together in ways we haven’t in many years, maybe not since 9/11,” Bellone said. “That’s what we should do.”

Bellone suggested the county didn’t have “time to spare to worry about partisan nonsense.”

He pointed out how he and Comptroller John M. Kennedy Jr. (R), who ran against Bellone to become county executive, have been “working closely together to address issues here. I’m hopeful that will continue.”

Stony Brook Closes Satellite ER

Stony Brook University is closing the emergency room field satellite in the South P Lot amid a decline in the number of patients.

The hospital will keep equipment inside the tents in case of future need. The health care workers who had been staffing the field site will return to the hospital.

Stony Brook had seen approximately 2,600 patients at the coronavirus triage sites.

The drive-through testing site in the South P Lot will remain open. That site has tested 27,515 patients.

Residents who would like a test need to make appointments in advance, by calling 888-364-3065. The site is open seven days a week, 7 a.m. to 7 p.m.

Stony Brook University Hospital’s Team Lavender, and a Staff Support Team, delivered care packages to the employees at the Long Island State Veterans Home. The team put together 170 containers filled with donated items from the community including gum, chapsticks, drinks and snacks. They also included trays of home-baked goods, crocheted ear savers, and masks made by a veteran.

Team Lavender volunteers include doctors, nurses, social workers, patient advocates, chaplains, a faculty and staff care team, employee assistance program and employee health program. The team provides emotional, spiritual and psychological support for faculty and staff after an adverse or unexpected event.

Team Lavender completed a successful pilot during the last year in the NICU and maternity units. Team Lavender has worked together with the Staff Support Team to provide hospital wide support. Their efforts, previously performed in-person, are now available virtually for faculty and staff.

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Amanda Groveman, a Stony Brook Medicine Quality Management Practitioner, holding a "My Story" poster for Kevin, who enjoys bowling among his hobbies. Photo from Stony Brook Medicine

Patients battling COVID-19 at Stony Brook University Hospital have allies who can see them and their lives outside the context of the current pandemic.

Thanks to a team of nurses at Stony Brook who are calling family members to gather information and putting together pictures the family members are sending, over 89 patients have received the kind of personalized support they might have gotten if their family and friend network were allowed in the hospital during the pandemic.

“You get everything,” said Amanda Groveman, a Stony Brook Medicine Quality Management Practitioner, who has worked at the hospital since 2006 and created a Power Point template for the information. Family members are sending pictures at of them during Christmas, of people playing various sports, of pets, of other family members, and even a wedding picture from the 1930’s.

Once the nurses gather this information, they print out two copies and laminate them. One copy goes in the room, where the patient can also see it, and the other is in the hallway, where the doctor or nurse who is about to walk in can get a broader look at the life of the patient in the bed on the other side of the door.

The effort, called “My Story,” is an extension of a similar initiative at the hospital for patients who have Alzheimer’s Disease and might also have trouble sharing their lives with the health care workers.

The nurses involved in the program include: Chief of Regulatory Affairs Carolyn Santora, Assistant Director of Nursing Susan Robbins, Director of Quality Management Grace Propper, Lisa Reagan, the patient coordinator and Nurse Practitioner April Plank.

“It’s not just a bullet point checklist,” Groveman said. “It’s creating a history of this patient.”

Some patients like to hear a particular type of music. Indeed, one patient routinely listened to so much “Willie Nelson, that was all he wanted to listen to.”

Grovemen said the contact with the family also connects the nurses to that family’s support network, which they now aren’t able to see in eerily empty waiting rooms.

“You speak to these families and then you feel like you do know this person well,” Groveman said. “At a certain point, it’s not just about the patient. It’s about the whole support system. You’re pulling not just for them, but for their whole family.”

The pictures serve as an inspiration for the nurses as well, who get to share their passion for pets or for sports teams.

These connections are especially important, as some patients have been in the ICU for weeks.

Each time a person leaves the hospital, the staff plays the Beatles song, “Here Comes the Sun,” which has also been encouraging to the hospital staff who has been treating them.

When Groveman returns to her family, which includes her husband Matt and their two children, each night, she puts her clothing in the washing machine and takes a shower before she enjoys her own family time.

“As soon as I walk in, they say, ‘No hug yet,’” Groveman said. Her kids have been “really good” about the new nightly pattern.

A by product of her new routine is that Groveman has also been washing her hands and wrists so often that she has developed what her daughter calls “lizard skin.”

She insists on disinfecting everything that comes in the house, which means that she has a collection of cardboard boxes on her porch that wait there until recycling day.

Amid all the public health struggles she and her fellow nurses see every day, she appreciates how Stony Brook has set up a room where nurses can meditate and relax.

Groveman said she’s surprised by the number of people who are coming in who are in their 30’s and 40’s. One of the more challenging elements of caring for patients is, for her, that she sees people who come in who are not in bad shape, but “unfortunately, with this, it can just be all of a sudden someone takes a downturn.”

Groveman had previously worked in pediatrics, where she said she recognized that any treatment for children also benefited the broader family.

“You are treating the family as well,” she said. “You really want to make that connection. Being a nurse is about making that connection.”

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Health care workers at Stony Brook University Hospital crowd together after the flyover April 28. Photo by Kyle Barr

Even as the emergency health care community is due for a break after an intense surge in patients who had COVID-19 finally subsides, hospitals are seeing an increase in demand for surgeries and procedures residents had put off amid the crisis.

About 10 days ago, Stony Brook University Hospital saw a rise in admissions that were unrelated to COVID-19, said Dr. Todd Griffin, the President of Medical Staff and Chair of the Department of Obstetrics, Gynecology and Reproductive Medicine.

Indeed, in the last few days, the non-COVID admissions have been higher than the COVID-driven admissions, Griffin said.

“Patients were staying at home so long” during the pandemic that some of them “had to go into the emergency room,” Griffin said.

Stony Brook had been at pandemic level D during the worst of the crisis and is now getting ready to transition to Pandemic level C, which will allow them to operate on more semi-urgent patients.

These patients either have chronic pain that needs surgical remedies, cancers that are low grade but where waiting more than 30 days could exacerbate the condition, spinal cases that, if left untreated, could lead to more permanent disabilities, or cardiac cases.

“We’re really looking at starting up semi-urgent cases first, then we’ll look at the elective cases” some time later, Griffin said.

A medical team is looking at these types of decisions, trying to determine what falls into the semi-urgent arena and what becomes more of an elective procedure.

Up until recently, the ambulatory surgery center had been acting as an Intensive Care Unit. The hospital is thoroughly cleaning that area to make sure it’s safe for reentry for the general patient population, Griffin said. They are also assessing whether they have the staff to address medical issues that extend beyond helping people battling the virus.

“We are still far from a return to business as usual,” the medical staff president said.

Stony Brook is making sure it has enough personal protective equipment. One of the challenges in preparing hospital rooms for future surgeries is that the material used to make the drapes is the same as the material for surgical masks and gowns.

“A lot of that material was diverted,” Griffin said. The hospital wants to make sure it has enough drapes to meet the medical need.

Patients coming to Stony Brook hospital will need testing for COVID-19 before they receive treatment. The hospital is also considering whether they can test visitors and how that would be done to limit exposure for everyone in the hospital.
Stony Brook Hospital is also considering testing staff and physicians. The availability of testing will determine how many tests they administer and how frequently.

Even during the pandemic, Stony Brook has still been conducting about 10 to 15 procedures per day, which is well below the 70 to 80 patients who typically received treatment.

The individual departments have remained in touch with patients throughout the coronavirus outbreak.

“Our outpatient offices have still been open,” Griffin said.

Indeed, separate from responses to COVID-19, some areas of the hospital have become even busier, including obstetrics and gynecology.

Over the last three or four weeks, the hospital has received about 80 to 100 transfer patients, which is considerably higher than the five to 10 it receives in a typical week.

Some of those patients are residents of New York City and came to Stony Brook because hospitals in other regions had stopped allowing a support person during delivery.

Additionally, Stony Brook has single bedded units in its maternity ward, which means mothers have their own room throughout the process.

“We were trying to have as normal an experience as we can in a pandemic,” Griffin said. “I am so proud of the staff and nurses during this difficult time. They created the best experience for patients possible.”

Even with the hospital scheduling some additional surgeries in the weeks ahead, however, Stony Brook will follow Gov. Andrew Cuomo’s (D) guidance, remaining at or below 70 percent capacity in the event of another surge in demand from COVID-19.

Griffin is concerned that he will “see a second surge during the summer,” which planners are keeping in the “backs of their mind” as they add more patients to the surgery schedule.

Additionally, the medical community has spoken broadly about the combination in the fall or winter of a second wave of coronavirus at the same time as rising infections from the flu.

As the hospital prepares for more surgery patients, they will continue with procedures that protect patients and hospital staff, which includes wearing masks and more rigorous and frequent hand washing.

“Patients need to understand that if they come to Stony Brook Medicine, they are coming to a safe environment,” Griffin said. Griffin suggested that “coming to the hospital is still safer than going to the supermarket.”

Update: This article has been updated to indicate that the number of OB transfers over the last three to four weeks has been a total of 80 to 100, rather than 100 per week over that same time period. It also indicates that Stony Brook is considering whether the hospital can test visitors and how that would be done and that it is getting ready to transition to Pandemic Level C.

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Barry Chandler delivers food to the Suffolk County Police Headquarters. Photo from Nissequogue Golf Club

It was a hole in one for Stony Brook University Hospital workers April 5 when the Nissequogue Golf Club donated 600 meals to the facility. The club followed up that act of kindness with a donation of 120 meals to the Suffolk County Police Headquarters in Yaphank April 16.

Nissequogue Golf Club staff members deliver food to SBU hospital. Photo from Nissequogue Golf Club

According to the club’s general manager, Barry Chandler, the hot, homemade meals included meatballs and rigatoni. The club also donated 25 cases of bottled water to the hospital.

Chandler approached the club’s president Art Seeberger with the idea of donating to the hospital and Seeberger then asked the club’s board for approval. The club’s president then made the initial contribution of $500, and Chandler matched it.

The planning process began with Chandler contacting the hospital to ensure all the details were covered before the delivery. The 1,600 meatballs, 200 pounds of rigatoni and 110 gallons of sauce which made up the first meals for hospital workers were prepared by the club’s chef Joseph Badalato and his kitchen crew. Chandler said meatballs were an easy choice for the meals.

“Our chef is Italian, and we love his meatballs,” he said. “So he gets the whole gang together in the kitchen, anyone who can help, and we start rolling meatballs based on his specifications.”

When it came to the delivery to Stony Brook University Hospital, club member Ann Shybunko-Moore lent her truck to transport the meals, and Seeberger, Chandler, Badalato and sous chef Vince Minelli made the delivery. Chandler said SBU had someone greet them at the door with carts and hospital employees brought the food in so the volunteers didn’t have to step inside the hospital.

According to the golf club manager, other hospitals and first responders were reaching out to its offices to see if they too may have their first responders fed by Nissequogue Golf Club. A wife of one of the workers at Suffolk County Police Headquarters heard about the golf club’s good dead and asked if food could be delivered to the Yaphank facility. Chandler said the club received a card after the delivery signed by more than 50 of the employees at headquarters.

The golf club staff is currently discussing the next group to feed, which most likely will be health care workers at another hospital.

Pictured, Nissequogue Golf Club staff members deliver food to SBU hospital, top and bottom left; bottom right Barry Chandler delivers food to the Suffolk County Police Headquarters. 

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Dr. Bettina Fries and her neighbor Agjah Libohova holding new face shields that will soon be put into the PPE pipeline at Stony Brook Medicine and many metro area hospitals. Photo from SBU

Her forecast calls for a better summer and a difficult fall and winter.

Bettina Fries, the Chief of the Division of Infectious Diseases at Stony Brook Renaissance School of Medicine, sees improvements in the battle against COVID-19 over the next few months, and then a return of stormy weather in the winter.

There will be “much, much less cases in the summer. The reason is that people are more outside and there is less tightness together, but we have to be careful.”

Indeed, a decline in cases of COVID-19 won’t signal a victory over the virus. As the fall approaches, a second wave could exacerbate the typical arrival of the seasonal flu.

“We have a hard winter ahead of us,” Fries acknowledged. As one of several principal investigators involved in efforts to develop an effective treatment for the virus, Fries is working to mitigate the effect of the pandemic.

Fries is overseeing Stony Brook’s involvement in a trial of Regeneron’s drug Sarilumab, which blocks the binding of interleukin-6 to its receptor. The Food and Drug Administration has already approved the drug to treat juvenile rheumatoid arthritis and for the cytokine storm brought on by the treatment of acute leukemia with CAR-T cells.

The work at Stony Brook is a part of Regeneron’s tests in 50 medical centers. At this point, Fries has recruited three of the six patients who will receive the treatment.

Stony Brook is also involved in other studies of potential therapeutics. Sharon Nachman, the chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, has given Remdesivir to two patients with severe symptoms. The drug, which was developed to treat Ebola and Marburg, targets and inhibits the RNA polymerase.

Meanwhile, Elliot Bennet-Guerrero, the Medical Director for Perioperative Quality and Patient Safety for Stony Brook Medicine plans to start a clinical trial of donated, post-convalescent plasma from COVID-19 patients. This approach dates back over 100 years, when serum made from immunized animals helped treat diphtheria.

While each of these approaches could provide relief and extend the lives of people suffering from the virus, Fries doesn’t expect a return to some semblance of normal until the development of a reliable vaccine, which could take another year or more.

Fries sees a potential legal battle developing as countries race to produce a vaccine. She believes the World Health Organization is the group most likely to succeed in ensuring that any effective treatment benefits all of humanity and not just the company or country in which it originated.

“The only organization in my opinion that would be able and have international support to oversee this and make sure this vaccine becomes accessible to everyone and is not getting hung up in patent or licensing disputes is the World Health Organization,” Fries said.

Fries said she believes the international community needs to come to an agreement well before scientists develop an effective vaccine.

“We need everybody in this world to become vaccinated,” Fries said. “It’s really important before we have a vaccine that the international community starts agreeing on what we are going to do if company XYZ in South Korea has the super vaccine first.”

Fries suggested that the American withdrawal from the WHO could prove to be a costly mistake to public health and to global efforts to combat the pandemic.

“Chances are high that the Chinese or Germans or South Koreans will have a vaccine before we do,” Fries said.

As for COVID-19, Fries said the consensus for the infection rate has changed over the last few months, as the virus has spread throughout the world. Indeed, each person who gets the virus now spreads it to about 5.7 other people, which is considerably higher than the rate of between 2.2 and 2.7 researchers had expected from earlier information.

While people who have endured life-threatening symptoms can become infectious, people are generally infectious before they are symptomatic.

As states and countries consider reopening from quarantines, lockdowns and shelter-in-place mandates, Fries said the most effective approach would likely involve a modified reopening with behavioral changes.

Hospitals and urgent care centers can and have changed the way they interact with residents who come into the emergency rooms. The longer-term transition for other businesses and enterprises is more challenging.

Bringing students back to colleges remains a difficult decision that schools around the country face over the next few months, particularly amid a situation in which information about hospitalization, mortality, and testing change by the day.

Sports like swimming and tennis may be able to resume without too many public health alterations, while opera and movie theaters may be more limited in how they can entertain audiences.

Separately, many people have already altered their health care routines, avoiding practices and procedures that could extend the quality and years of their lives. People may not have gotten their chemotherapy and may have missed the chance to get bypass surgery or stents.

“There’s collateral damage we don’t even know yet,” Fries said, “That’s going to be huge.”

Even if the mortality rate is closer to 0.5 percent, the overall number of infections and hospitalizations have “hijacked” the health care system, which can lead to a lower level of care for everyone else, Fries said.

The health care system has been “completely emergency-based for the last 50 days,” Fries observed.

As the country and world approach what might be more of a summer reduction in the numbers, Fries urged ongoing vigilance, even if there are no new cases for an entire month. She suggested that governmental oversight and regulation in connection with a strong health department can help manage through the next wave of cases.

The health care system has had to conquer the seemingly intractable problem of viral deaths, such as from the human immunodeficiency virus, or HIV.

COVID-19 is “very similar in the sense that there was so much despair at the beginning,” Fries said. “When you don’t have a cure, you need to attack a disease with different methods and be okay that you’re not going to cure it, but that you’re going to contain it.”

Fries urged patience as people confront the uncertainty ahead. The ongoing use of masks can help people confront the public health threat that she hopes a vaccine helps conquer.

One of the many clear lessons from this crisis, Fries said, is that those dealing with the public health threat needed to approach it with an understanding of the disruption to the supply chains, with everything from personal protective equipment shortages to ventilators in the right places to adequate staffing of doctors, nurses and other health care professionals.

The garment industry in New York is starting to make plastic coats, Fries said. “Why didn’t we start making that eight weeks ago?”

The same approach also applies to medicines. A multi-disciplinary approach using artificial intelligence could anticipate what hospitals and urgent care centers need, bringing the necessary and vital field of supply chain logistics into this enormous effort.

Ultimately, Fries expects a balance between best practices to keep people safe and the human need for interaction and full engagement professionally and socially.

“We can’t have everybody stay at home,” Fries said. “We have to find a new way of interacting and seeing each other.”
This article was amended April 24 to change the nature in which the drug Remdesivir works.

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From left, John Brittelli, Jon Longtin, and Dimitris Assanis, who are working on an early prototype of the CoreVent 2020. Photo from Stony Brook University.

Working against time and a potential shortage of life-saving ventilators, Stony Brook University scientists designed their own version, which they hoped no one would have to use.

In the course of 10 days, a team led by Jon Longtin, College of Engineering and Applied Sciences Associate Dean of Research and Entrepreneurship and professor of mechanical engineering, designed, built and tested a cheaper and easier ventilator, which they called CoreVent2020. They have spoken with a company in Shirley called Biodex Medical Systems, which could make as many as 30 of the originally crafted machines per day.

“It was an all-encompassing task,” Longtin said. “When we started this, COVID-19 cases were growing exponentially in the New York area. By following the curve at that point, we were going to run out of ventilators in a matter of one or two weeks.”

Indeed, just a few weeks ago, Suffolk County and New York State were still climbing the curve, without knowing when the peak would arrive. That meant that each day, the number of people hospitalized increased dramatically, as did the number of people who needed ventilators in the Intensive Care Unit.

The parts for the system Longtin, John Brittelli, a clinical professor in the Respiratory Care Program, and Dmitris Assanis, an assistant professor of mechanical engineering at Stony Brook, created cost about $2,000. This includes the cost for the arduino control panel, which is a computer board people have programmed to run their washing machines and to turn on lamps. The total cost compares with a price tag of about $30,000 for a regular ventilator.

The CoreVent 2020 favors a hospital setting, Longtin said, because it runs on medical compressed oxygen and compressed air.

“Most hospitals have compressed air, which we were able to use to make the design much simpler,” Longtin said.

Chris Paige, an anesthesiologist at Stony Brook University Hospital who worked on the ventilator, coined the term CoreVent, which suggests a “core” set of needed capabilities, but nothing more, Longtin explained in an email.

The researchers wanted to create a machine that didn’t have any proprietary parts, which would make the manufacture and distribution of the system considerably easier. The researchers wanted to make sure they could get the parts they needed and could still move forward even if a particular part from a specific manufacturer wasn’t available.

“Anything we used, we could buy from a number of different suppliers,” Longtin said. “As long as the specifications were the same, the design was simple and reliable.”

Longtin said the limits of time and resources, akin to the engineers at the National Aeronautics and Space Administration who helped bring home the damaged Apollo 13 rocket with its three-member crew, were omnipresent in designing and building the alternative ventilator system.

Longtin was grateful for the help and support of people in the engineering and medical side.

Longtin said he appreciated the opportunity to work together with his colleagues in the medical community and not only to build this alternative ventilator but also to build relationships across the Stony Brook community.

“I look forward to building upon these new relationships for other projects,” Longtin said. “Engineering and medicine will take a serious look at this and ask how we can work together to be more prepared in the future.”

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Frequently clean household surfaces, especially high-touch surfaces such as handles, doorknobs, appliances, etc. Photo from METRO

By Susan V. Donelan, MD, FSHEA

Susan V. Donelan, MD, FSHEA

During the coronavirus pandemic, everyone has been trying to ready themselves and their households for a possible long stay at home. Stories abound about toilet paper and hand sanitizer shortages, not to mention water, milk and bread. Even ice cream is in short supply.

To be well prepared, experts recommend having a two-week supply of food on hand, including pet food, plus a 90-day supply of prescription medications and a thermometer. Another part of prudent planning is to prepare for the possibility that a member of your household will become infected.

Your goal should be to prevent one family member’s exposure from becoming multiple exposures that spread the virus throughout your entire family. Here are some safe practices to take:

• The exposed person should wear a surgical mask, if available, to prevent airborne respiratory droplets from infecting others. If a surgical grade mask is not available, a homemade one should be used.

• Regardless of whether the exposed person is wearing a mask, other family members should stay at least six feet away from the exposed person. Those who must come in closer contact should also wear surgical masks when caring for their loved one.

• If possible, the exposed person should sleep alone in a separate bedroom and use a separate bathroom from the other members of the household.

• Common areas such as dens and kitchens should not be shared as long as the exposed person is infectious, if possible. Common surfaces should be regularly sanitized; commercial products are sufficient. Shared spaces should be well ventilated (e.g., keep windows open), when possible.

• Meals should be eaten in separate locations. If possible, create separate cooking and food storage locations for the infected family member. Use separate linen and eating utensils for your loved one. Dishes and utensils should be placed into the dishwasher and are safe to handle once the washing and drying cycles are completed. If a dishwasher is not available, wash dishes and utensils in hot, soapy water while wearing dishwashing gloves. 

Photo from METRO

• Caring for someone with mild to moderate symptoms of coronavirus is similar to caring for someone with the flu. Give them supportive care, fluids, soups and over-the-counter cough medicines and pain relievers to ease symptoms. Have them take their temperature regularly. 

• If someone at home with coronavirus begins to have chest pain, is unable to complete sentences due to breathlessness, has dusky skin, is unable to eat and drink, or has other concerning signs of getting worse, they should be brought to the local emergency department for further evaluation.

• Perform hand hygiene after any type of contact with your loved one. The exposed person should clean and disinfect surfaces daily that are frequently touched in the room where he or she is staying. They should also clean and disinfect their bathroom and toilet surface at least daily.

• Clean the person’s clothes, bed linens and bath and hand towels using regular laundry soap and water at the hottest permissible setting. Use a dryer if available. Use gloves when cleaning surfaces or handling clothes or linen soiled with body fluids. 

• Healthy members of the household should frequently clean household surfaces, especially high-touch surfaces such as handles, doorknobs, appliances, etc.

Establish a communication link with your healthcare provider ahead of time, know where your closest hospital is, and have a checklist of emergency supplies if you need to take your loved one to the hospital. If they are so sick or weak that they can’t eat, drink or go to the bathroom, call a doctor.

Detailed guidance about caring for people at home is available from the World Health Organization website: www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts

The best advice? Take care of yourself and your loved ones. Get rest, eat well and exercise however you can. Maintain social distancing. Pay close attention to hand hygiene, and keep your hands off of your face. We all have a role to play to stop the spread and protect each other during this global pandemic.

Susan V. Donelan, MD, FSHEA is Medical Director of the Healthcare Epidemiology Department and Assistant Professor, Infectious Diseases at Stony Brook Medicine.

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Dr. Bettina Fries and her neighbor Agjah Libohova holding new face shields that will soon be put into the PPE pipeline at Stony Brook Medicine and many metro area hospitals. Photo from SBU

By Kyle Barr and David Luces

In other years, the first day of April dawning would have been a time for celebration and maybe a few pranks. This year, during the coronavirus crisis, not many were up for such jubilation. 

In a daily call with reporters, Suffolk County Executive Steve Bellone (D) said as of today there were now 69 individual deaths from COVID-19 in Suffolk County. 25 of those individuals died in the past 48 hours and 16 in the past day. The vast majority of deaths were of people who had underlying medical issues.

“We are going to get through this but it is going to get worse before it gets better,” said County Executive Steve Bellone. “We all have the power to make this better by practicing social distancing. If you feel sick stay home.”
The total for all of New York was even more staggering, with Gov. Andrew Cuomo (D) announcing the morning of April 1 nearly 400 people have died in New York State in the span of 24 hours. 

Cuomo compared it to the movie “Groundhog Day,” where the main character keeps experiences the same day over and over.

“When does it end? how does it end? I don’t know,” he said during his morning press briefing.

In Suffolk, the current number of people confirmed with the virus is 7,605. Currently over 25,000 have been tested, including 5,400 from the Stony Brook site in the South P lot as of Wednesday morning, Bellone said. 

The County Executive also emphasized the 2020 Census, saying as we’re in the midst of this battle, we need to recognize the economic human service impacts. 

“If we don’t do what we need to do we will be experiencing shortfalls in aid for the next 10 years,” Bellone said. “We have to make sure we’re getting those census documents filled out.” 

The county executive added Child Protective Services continues to do house visits and they have done as many interviews as they can telephonically.

“The government does not close — we are here to deal with crises,” he said. “CPS is one of those they are continuing to operate.”

Stony Brook University Begins Drug Trials to Combat Coronavirus

In a COVID-19 briefing update, Stony Brook Medicine officials said that the hospital has begun a number of clinical trials designed to identify effective therapies for critically ill patients.

Remdesivir, an antiviral drug developed to treat two other RNA viruses, Ebola and Marburg, has been administered to two patients with severe coronavirus. The clinical trials on the drug are led by Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. Officials said the drug has appeared to be effective in treating COVID-19 in both China and Washington State. 

Doctors will also be involved in a Regeneron-sponsored clinical trial on Sarilumab (Kevzara), a monoclonal antibody which blocks binding of interleukin-6 to its receptor. Sarilumab is already FDA approved for the treatment of juvenile rheumatoid arthritis, and more recently for the cytokine storm that accompanies the use of CAR-T cells for acute leukemia. The first Regeneron patient was recruited on March 30. 

Stony Brook Medicine will soon be launching a clinical trial of donated, post-convalescent plasma from COVID-19 patients “very soon,” based on the level of antibody titers to SARS-CoV2 in the donor plasma. Serum or plasma therapy for infectious diseases dates to the 1890s, when serum made from immunized animals provided the first effective treatment for Clostridium tetani and Corynebacterium diphtheriae.

In addition, SBU professor Lily Mujica-Parodi has been part of a national effort to employ a wearable technology device called Oura to collect sufficient physiological data, and use deep learning algorithms to predict the onset of SARS-CoV2 infection. This type of device would be most productive and predictive in hospitals where there is a large number of healthcare workers in high-risk-for-infection roles. 

 LI Company to Begin New Face Shield Production. 

Clear-Vu Lighting, a Central Islip-based design company, will begin manufacturing an order of 20,000 new face shields that will be deployed to Stony Brook University Hospital. Mass production  is expected to start by early April. Clear-Vu Lighting is gearing up with an expectation to produce 40,000 faceshields per day and approximately 1.2 million per month. Production of face shields to Stony Brook will include supplies for Stony Brook University Hospital and all affiliated hospitals on Long Island. 

Preventing a Possible Shortage of Ventilators

Due to the projections of the COVID-19 pandemic, Stony Brook University Hospital is suggesting it may be required to use a single ventilator for up to two patients in case there is a shortage once the number of patients is at its peak. In a Stony Brook Medicine research laboratory, medical professionals are working on a solution to ventilating multiple patients with one ventilator. Putting two patients on one ventilator requires matching patients with similar characteristics, such as sex, height, age and lung sizes, to avoid one patient being over ventilated and the other being under ventilated.

Stony Brook said researchers and doctors are examining the forces that cause unequal distribution of lung volumes and airway pressures, while using complex test models of diseased lungs. With this research, doctors are able to vary airway resistance and compliance and mimic acute respiratory distress syndrome-like conditions, which allows to test the use of inline valves and resistance devices to solve these problems. 

Addressing the Growing Need for Additional Staff

To address potential staff shortfalls, the medical school is preparing to allow graduating students to volunteer on the front lines of the epidemic while awaiting the eventual surge of patients.

The Renaissance School of Medicine at Stony Brook University is allowing senior medical students to graduate in early April so they can begin their professional career as a physician at Stony Brook University Hospital. They will be able to work under the supervision of residents, fellows and attending physicians to address the growing number and complexity of patients being admitted to our hospital, precipitated by the COVID-19 pandemic. The graduates would then proceed to begin their residencies July 1.

 

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Stony Brook University Hospital. File photo

The Army Corps. of Engineers has awarded a $50 million contract to New York-based Turner Construction Company to begin building a hospital extension to handle the expected surge in hospital demand in the next few weeks amid the coronavirus pandemic.

With assistance from Suffolk County contractors and sub contractors, Turner will begin building the facility immediately and is expected to complete construction by April 18.

Stony Brook University Hospital and other area medical care facilities will use the hospital extension for patients who have come to the hospital for health care issues that don’t involve COVID-19, freeing up bed space in the main hospital and in other centers to treat patients with the virus.

The construction of the 1,000-bed facility is part of a Governor Andrew Cuomo’s (D) effort to double the number of hospital beds throughout the state within the next few weeks.

Construction on the hospital extension will start “right away,” said U.S. Rep. Lee Zeldin (R-NY1). The Army Corps. of Engineers has been “getting a running start on this project,” Zeldin said.

Zeldin was pleased that Anthony Ciorra, a senior program manager for the Army Corps. of Engineers, would be working closely on the project.

Ciorra is someone Zeldin has “interacted with very frequently, ” he said, adding the man is “intimately familiar with the First Congressional District. He has been a great resource throughout the years” and is able to cut through the red tape and get the job done.

Ciorra will be working under Col. Thomas Asbery, who is the commander for the New York District.

“Both of them have played an instrumental role in getting this to the point where it’s at right now,” Zeldin said.

The congressman said he expected local companies to contribute to the new construction.

“It would very much be my hope and expectation that Turner would be utilizing local businesses for supplies and labor to complete this project,” he said.

Separately, Stony Brook University said Batelle has added its Critical Care Decontamination System, which will allow the university to reuse N95 masks, among other personal protective equipment. The Batelle system will start decontaminating up to 80,000 masks per day by the end of this week. Before decontaminating the masks, people will inspect them to make sure masks with rips, tears, makeup, or other fluids don’t go through the process.

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