Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, spoke with TBR Newspapers to discuss the current state of vaccinations in Suffolk County, the return to school in the fall, workplace issues, and tic-borne challenges for residents. Please find below an abridged version of the interview below. If you’d like to listen to the entire interview, view the video above.
COVID-19
TBR: How close are we to the 70% threshold for herd immunity to COVID-19?
Popp: We were hoping vaccination would start rolling out pretty fast and actually that happened. Over the last several months, more and more people got vaccinated. Right now, it’s open more or less like just show up and you can get a vaccine. You don’t even need an appointment anymore. The number of people vaccinated in Suffolk County is, percentage-wise, around 55% of eligible persons.
TBR: What about the rates at which people are seeking the vaccines? Has that slowed?
Popp: The number getting vaccinated has somewhat plateaued. The most eager people who wanted to get vaccinated did. Now, we’re seeing people who are actually still willing to get vaccinated and doing it and also some of people who are on the fence getting more information and speaking with other people who actually received the vaccine. More and more people are getting confident that the vaccine is safe, efficacious, and I hope this trend will continue.
TBR: What about schools in the fall? Will students return without masks and at full capacity?
Popp: At this point, the rate of coronavirus in Suffolk County is very low and has been decreasing since March steadily and is at almost a minimum even compared to last year. The question is, what will happen down the road? What will happen in the fall? We know that coronavirus has a propensity to be more active in cold environment. It’s hard to predict, because of these variants coming from different parts of the world. We should be hopeful that the fall will look good as long as more and more people get vaccinated. Hopefully, by September, we’ll reach about 70%, then going back to school will be easier.
TBR: As offices reopen and people return to work, how should companies handle rules, especially if some people aren’t vaccinated?
Popp: Offices vary in size, the number of people, how many are sitting in one room, close to one another. One has to make a decision on a case-by-case basis. Ideally, everyone working in one office should be vaccinated. It’s a difficult situation, mandating people to get vaccinated. It’s a fine line between your personal liberties and public policies.
TBR: When might a booster be necessary?
Popp: The need for the booster is being debated [as] the efficacy of the vaccine, the immunogenicity of the vaccine is probably higher than what I expected to see. From the early stages of December, we do find that they hold their antibodies quite well. The expectation is that this could last maybe two years or so. We don’t know that yet. One has to give it time and really find out.
TBR: What about weddings?
Popp: The wedding situation is quite a big situation. A lot of people have postponed the wedding in the hopes of having a real thing later on. The approach people have taken varied from A to Z. There is no cookie-cutter way to say this is the right thing to do and that’s the wrong thing to do. A friend of mine getting married is asking every person to be vaccinated. If you’re not vaccinated, you’re not allowed in the wedding. This is the decision of the groom and bride. Other venues are obviously more open, and they invite everybody and so forth. In the end, you have to be comfortable with the decision you make and you’re going there to have fun, you can’t have fun and celebrate if you’re truly nervous.
Tick-borne diseases
TBR: What about tick-borne diseases? Is there messaging people should keep in mind?
Popp: In the last three years, I have seen more tick-related diseases than before. We’re not talking only Lyme disease, could be also babesiosis, ehrlichiosis, and Rocky Mountain Spotted fever. Rocky Mountain Spotted fever used to be very unusual on Long Island. Now, we do see cases. I have already seen cases this year. When you go somewhere walking or hiking in some woods or meadows that may have ticks that may be around there, what you do at the end of the day when you come home, you get your shower, do a body check. Have someone else look at areas you can’t see well on your back, back of your legs.
From left, John Inglis and Richard Sever. Photo from CSHL
By Daniel Dunaief
Scientists rarely have people standing at their lab door, waiting eagerly for the results of their studies the way the public awaits high-profile verdicts.
That, however, changed over the last 16 months, as researchers, public health officials, school administrators and a host of others struggled to understand every aspect of the basic and translational science involved in the Sars-Cov2 virus, which caused the COVID-19 pandemic.
With people becoming infected, hospitalized and dying at an alarming rate, businesses closing and travel, entertainment and sporting events grinding to a halt, society looked to scientists for quick answers. One challenge, particularly in the world of scientific publishing, is that quick and answers don’t often mesh well in the deliberate, careful and complicated world of scientific publishing.
The scientific method involves considerable checking, rechecking and careful statistically relevant analysis, which is not typically designed for the sharing of information until other researchers have reviewed it and questioned the approach, methodology and interpretation.
The pandemic changed that last year, increasing the importance of preprint servers like bioRxiv and medRxiv at Cold Spring Harbor Laboratory, which provide a way for researchers to share unfiltered and unchecked information quicker than a scientific review and publishing process that can take months or even years.
The pandemic increased the importance of these preprint servers, enabling scientists from all over the world to exchange updated research with each other, in the hopes of leading to better basic understanding, diagnosis, treatment and prevention of the spread of the deadly virus.
The importance of these servers left those running them in a bind, as they wanted to balance between honoring their mission of sharing information quickly and remaining responsible about the kinds of information, speculation or data that might prove dangerous to the public.
Richard Sever and John Inglis, Assistant Director and Executive Director of Cold Spring Harbor Laboratory Press, created pandemic-specific criteria for work reporting potential Covid-19 therapies.
“Manuscripts making computational predictions of COVID-19 therapies are accepted only if they also include in vitro [studies in test tubes or with live cells] or in vivo [studies in live subjects] work,” the preprint directors wrote in a recent blog. “This restriction does not apply to non-covid-19 work.”
Inglis and Sever continue to decline research papers that might cause people to behave in ways that compromise public health.
“We are simply doing our best to tread carefully in the early days of clinical preprints, as we gain experience and bias our actions toward doing no harm” the authors wrote in their blog.
In the first few months after the pandemic hit the United States, the pace at which scientists, many of whom pivoted from their primary work to direct their expertise to the public health threat, was the highest bioRxiv, which was founded in November of 2013, and medRxiv, which was started in June of 2019, had ever experienced.
These preprint servers published papers that wound up leading to standards of care for COVID-19, including a June research report that appeared on June 22nd in medRxiv on the use of the steroid dexamethasone, which was one of the treatments former President Donald Trump received when he contracted the virus.
The rush to publish information related to the virus has slowed, although researchers have still posted over 16,000 papers related to the virus through the two pre-print servers. MedRxiv published 12,400 pandemic-related papers since January of 2020, while bioRxiv published over 3,600.
At its peak in late March of 2020, medRxiv’s abstract views reached 10.9 million, while downloads of the articles were close to five million.
Currently, bioRxiv is publishing about 3,500 papers a month, while medRxiv put up about 1,300 during a month. Close to 60 percent of the medRxiv papers continue to cover medical issues related to the pandemic.
The numbers of page views are “not anywhere near the frenzy of last year,” Inglis said in an interview.
With the volume of papers still high, people can receive alerts from the preprint servers using parameters like their field of interest or word searches.
“The real question is how to sort out the gold from the dross,” Inglis said. While some people have suggested a star system akin to the one shopping services use, Inglis remained skeptical about the benefit of a scientific popularity contest.
“Have you looked at the stuff [with four or five stars] on Amazon? It’s one thing if you’re buying a widget, but it’s different if you’re trying to figure out what’s worthwhile science,” he said.
Other organizations have reviewed preprints, including the Bloomberg School of Public Health at Johns Hopkins.
“By sheer diligence, the [Johns Hopkins team] go into medRxiv mostly and simply pick out things they think are striking,” Inglis said.
At the same time, a team of researchers led by Nicolas Vabret, Robert Samstein, Nicolas Fernandez, and Miriam Merad created the Sinai Immunology Review Project, which provides critical reviews of articles from the Cold Spring Harbor Laboratory preprint sites. The effort ranks COVID-related preprints according to their immunological relevance. Fernandez created a dedicated website to host and integrate the reviews. The group also worked with Nature Reviews Immunology to publish short weekly summaries of preprints, according to a comment piece in that journal.
BioRxiv and medRxiv were founded on the belief that early sharing of results as preprints would speed progress in biomedical research, better equipping scientists to build on each other’s work.
“My team is proud to have contributed to the response to this worldwide human tragedy,” Inglis said. “We’re also glad we made the decision to set up a separate server for health science, in which the screening requirements are different and more stringent.”
Inglis explained that the pre-print servers have “learned a lot in the past year” about providing information during a crisis like the pandemic. “If another pandemic arose, we’d apply these learnings and respond immediately in the same way.”
You don’t have to look hard to see them alongside the road. They aren’t even always on the sharpest curves or the steepest hills.
There, along the median or over there, by the right side of the road, are the homemade crucifixes, the flowers, the stuffed animals and the personal effects of people who never made it wherever they were going, their lives ending on or near asphalt as other vehicles collided with theirs.
My family recently took a road trip, where we easily could have become another statistic, and our family or friends could have just as easily been visiting the spot where it ended for one, two, three or all four of us.
I was driving during a recent weekend, excited by the open road and eager to remove the family from the neighborhood patterns that have defined our lives for well over a year.
My wife navigated, checked her email, exchanged texts with friends, and regularly asked if I wanted her to drive, if I needed a drink, or if I was hungry.
Our son was napping behind me, his head tilted back and to the left. Our daughter was immersed in virtual interactions with her friends, head down, a Mona Lisa smile plastered on her face.
With my peripheral vision, I traced the flow of the taller and shorter trees that passed by, the familiarity of the Texas, Indiana, Ohio and California license plates on nearby cars and trucks, and the click, click, click of the road that churned beneath our wheels.
Up ahead, the driver of one of the thousands of SUVs that dot the American landscape hit his brakes. My wife instantly saw it and closed her eyes. Unlike me, she typically hits her brakes as soon as she sees the red lights at the back of the car in front of her.
I immediately take my foot off the accelerator, where it hovers over the brake. As we rapidly approached the car in front of us, I applied the brake with some force, coming to an almost complete stop just feet before reaching the bumper.
I exhaled in relief, while immediately hitting the hazards. I wanted the cars behind me to know I wasn’t merely touching my brakes, but that I, and all the other cars around me, were stopping.
For a moment, I chatted with my wife. I have no idea what she or I was saying, when I noticed a truck coming towards at an incredible rate of speed.
“Hold on! This isn’t good!” I shouted, waking my son and drawing my daughter away from her phone.
I reflexively tapped my accelerator and drove my car directly towards the nearly stopped SUV on my right side. The truck, meanwhile, dove into the thin shoulder.
As it flew by, the truck somehow missed us completely. The car next to me honked in frustration, as the driver, who must have moved to her right, glared. I wanted to tell her that a truck might have crushed our family if the driver and I hadn’t each made last second adjustments.
Her lane kept moving, and she likely didn’t give my sudden maneuver another thought. With my hands in a vice grip on the wheel and my breathing rapid, I stared at the truck in front of me. I wasn’t sure whether I would have liked to punch or hug the driver, who didn’t notice me slowing down, see my hazard lights or leave himself enough room to stop. At the same time, though, he — and it could have been a woman, because I never saw the driver — turned onto the small shoulder, finding just enough space to squeeze past me without destroying my car, my family or my life.
For the next several minutes, I struggled to drive, as the image of the speeding truck with nowhere to go in my rear view mirror replayed itself in my head.
“Are you okay? Do you need me to drive?” my wife asked anxiously.
My family and I were okay. We weren’t a part of a sad story that ended on an American highway. Skid marks left on the road weren’t a marker for the final seconds of our lives.
We are grateful for the combination of factors that turned a close call into a near miss. Perhaps this happened for a reason beyond giving us more opportunities to extend the journeys of our lives. Perhaps one of the purposes is to provide a warning to everyone else to remain vigilant, to brake early and to stay sharp and focused on the roads.
Xiaoning Wu at her recent PhD graduation with Kevin Reed. Photo by Gordon Taylor
By Daniel Dunaief
If they build it, they will understand the hurricanes that will come.
That’s the theory behind the climate model Kevin Reed, Associate Professor at the School of Marine and Atmospheric Sciences at Stony Brook University, and his graduate student Xiaoning Wu, recently created.
Working with Associate Professor Christopher Wolfe at Stony Brook and National Center for Atmospheric Research scientists, Reed and Wu developed an idealized computer model of the interaction between the oceans and the atmosphere that they hope will, before long, allow them to study weather events such as tropical cyclones, also known as hurricanes.
In his idealized program, Reed is trying to reduce the complexity of models to create a system that doesn’t require as much bandwidth and that can offer directional cues about coming climate change.
“When you’re trying to build a climate model that can accurately project the future, you’re trying to include every process you know is important in the Earth’s system,” Reed said. These programs “can’t be run” with university computers and have to tap into some of the biggest supercomputers in the world.
Reed’s work is designed to “peel back some of these advances that have happened in the field” which will allow him to focus on understanding the connections and processes, particularly between the ocean and the atmosphere. He uses fewer components in his model, reducing the number of equations he uses to represent variables like clouds.
“We see if we can understand the processes, as opposed to understanding the most accurate” representations possible, he said. In the last ten years or so, he took a million lines of code in a climate model and reduced it to 200 lines.
Another way to develop a simpler model is to reduce the complexity of the climate system itself. One way to reduce that is to scale back on the land in the model, making the world look much more like something out of the 1995 Kevin Costner film “Waterworld.”
About 30 percent of the world is covered by land, which has a variety of properties.
In one of the simulations, Reed reduced the complexity of the system by getting rid of the land completely, creating a covered aqua planet, explaining that they are trying to develop a tool that looks somewhat like the Earth.
“If we could understand and quantify that [idealized system], we could develop other ways to look at the real world,” he said.
The amount of energy from the sun remains the same, as do the processes of representing oceans, atmospheres and clouds.
In another version of the model, Reed and Wu represented continents as a single, north-south ribbon strip of land, which is enough to change the ocean flow and to create currents like the Gulf Stream.
The expectation and preliminary research shows that “we should have tropical cyclones popping up in these idealized models,” Reed said. By studying the hurricanes in this model, these Stony Brook scientists can understand how these storms affect the movement of heat from around the equator towards the poles.
The weather patterns in regions further from the poles, like Long Island, come from the flow of heat that starts at the equator and moves to colder regions.
Atlantic hurricanes, which pick up their energy from the warmer waters near Africa and the southern North Atlantic, transfer some of that heat. Over the course of decades, the cycling of that energy, which also reduces the temperature of the warmer oceans, affects models for future storm systems, according to previous studies.
Reed said the scientific community has a wide range of estimates for the effect of hurricanes on energy transport, with some researchers estimating that it’s negligible, while others believing it’s close to 50 percent, which would mean that hurricanes could “play an active role in defining” the climate.
Reed’s hypothesis is that a more rapid warming of the poles will create less of an energy imbalance, which will mean fewer hurricanes. This might differ in various ocean basins. He has been studying the factors that control the number of tropical cyclones.
Reed and Wu’s research was published in the Journal of Advances in Modeling Earth Systems in April.
Wu, who is completing her PhD this summer after five years at Stony Brook, described the model as a major part of her thesis work. She is pleased with the work, which addresses the changing ocean as the “elephant in the room.”
Oftentimes, she said, models focus on the atmosphere without including uncertainties that come from oceans, which provide feedback through hurricanes and larger scale climate events.
Wu started working on the model in the summer of 2019, which involved considerable coding work. She hopes the model will “be used more widely” by the scientific community, as other researchers explore a range of questions about the interaction among various systems.
Wu doesn’t see the model as a crystal ball so much as a magnifying glass that can help clarify what is happening and also might occur in the future.
“We can focus on particular players in the system,” she said.
A native of central China, Wu said the flooding of the Yangtze River in 1998 likely affected her interest in science and weather, as the factors that led to this phenomenon occurred thousands of miles away.
As for her future, Wu is intrigued by the potential to connect models like the one she helped develop with applications for decision making in risk management.
The range of work she has done has enabled her to look at the atmosphere and physical oceanography and computational and science communication, all of which have been “useful for developing my career.”
I’m not much of a planner. I put together professional plans, creating a schedule for stories I’d like to research and write, and I coordinate calls and meetings all week, but I don’t tend to go through the calendar to figure out when to visit socially with friends and family or to attend cultural events.
This summer, however, I’m incredibly grateful for the opportunity to look at the calendar and consider a wide range of activities that would have been difficult or impossible a year ago.
I’m delighted to plan to visit with my extended family. I haven’t seen my brothers in over 19 months. I have visited with them on the phone and zoom, but that’s not nearly the same thing as seeing them in person, throwing a ball with them, flying a kite off the beach or just sitting on the couch and having a free-flowing conversation.
I am also delighted to consider planning a trip to museums. On one of our first dates, my wife and I went to the Metropolitan Museum, where we wandered slowly through the exhibits, continuing to build on our relationship even as we studied the artifacts left behind by the generations that fell in love and married hundreds of years earlier. I recall wandering through those wide hallways close to a quarter of a century ago, listening to my wife’s stories and delighting in laughter that, even now, provides validation and meaning to each moment.
I am hoping to travel to Washington, D.C., this summer, to see the air and space museum. Each of the planes hovers overhead, and the space capsules from the early days of the NASA program are inspirational, giving me a chance to picture the world from a different vantage point, seeing the shimmering blue waters that cover the Earth.
I have watched planes fly overhead throughout the pandemic, but I haven’t ventured to the airport or onto a plane. I’m looking forward to the opportunity that flight provides to turn trips that would take over 10 hours into one- or two-hour flights.
Visiting family, friends and strangers in different areas, eating foods that are different and unfamiliar and experiencing life outside of the small circles in which we’ve restricted ourselves opens up the possibilities for the summer and beyond.
My son can prepare for the start of college and my daughter for a return to college with the hope that they can enjoy more of the academic, social, extracurricular and community service experiences that they imagined when they envisioned these years of growth, development and, hopefully, independence.
I spoke with a scientist recently who told me that the inspiration for a work he’d just completed came from a conversation he had during a conference a few years ago. He had been sitting in an auditorium, listening to a speech, when he and a stranger exchanged thoughts about the implications of the work. From that interaction, he started a new project that became a productive and central focus of his research efforts. As soon as conferences are back on the calendar, he hopes to return to the road, where such unexpected and unplanned conversations can trigger inspiration.
To be sure, I recognize that the realities of travel and planning don’t always dovetail with the hopes and expectations. I recently visited with our extended community at a social gathering, where I stood downwind of someone who wore so much cologne that I couldn’t taste the food I was eating.
I’m sure there’ll also be lines, traffic jams and literal and figurative turbulence as I leave our home cocoon.
Still, this summer, I’ll be grateful for the opportunity to do so much, including and especially, the chance to plan.
Dr. Paolo Boffetta, who joined Stony Brook University as Associate Director for Population Sciences in the Cancer Center in the midst of the pandemic last April, asks the kinds of questions doctors, scientists and non-scientists also raise when they look at illnesses among groups of people.
An epidemiologist who worked for 20 years at the World Health Organization and at Mt. Sinai Hospital in New York City for 10 years, Boffetta joined Stony Brook because he saw an opportunity to replicate the kind of success he and others had at Mt. Sinai, where he helped the institution earn a National Cancer Institute designation. Cancer centers can apply for NCI designation when they have a well-established portfolio of research.
Dr. Paolo Boffetta
“The idea to try to get the Cancer Center” at Stony Brook “to the NCI level was very appealing,” Boffetta said. Stony Brook was looking to build out its population sciences work.
In addition to the big picture goal of helping Cancer Center Director Yusuf Hannun and other researchers earn that designation, Boffetta has partnered with several scientists at Stony Brook and elsewhere to address questions related to various illnesses.
Boffetta has applied for $12 million in funds over six years from the National Cancer Institute for a new water project.
The research will recruit people who are over 50 years old across several towns, primarily in Suffolk County to explore the link between the potential exposure these residents had to different chemicals in drinking water and types of cancers.
“The main idea is that people may be exposed to carcinogens through drinking water according to where they have been living,” Boffetta said.
The scientists will follow these residents over time to determine the health impact of their town of residency. “If this is funded, this will be a major project that will involve many institutions,” he added.
The chemicals they will study include nitrates, chlorinated solvents, 1,4-dioxane, and perfluoroalkyl substances.
While he awaits word on potential funding for the water effort, Boffetta and others are looking at another project to explore the link between various environmental factors and bladder cancer. This is not limited to drinking water contamination. The group plans to analyze tumor samples to see whether they can detect fingerprint mutations.
World Trade Center Studies
Boffetta also plans to continue and expand on work he’s done at Mt. Sinai with responders of the World Trade Center attacks, a group that has received considerable attention from numerous scientists at Stony Brook.
He has been “doing a number of quite detailed analyses on cancer, including survival of workers and responders to developing cancer,” he said. The WTC survivors are enrolled in a medical monitoring treatment program, sponsored by the Centers for Disease Control, which means they “should be getting good cancer care.”
Boffetta has been comparing their survival to the population at large in New York, analyzing how the risk of cancer evolved over the almost 20 years since the attacks.
Boffetta has started to look at one particular new project, in which he studies the prevalence of clonal hematopoiesis of indeterminate potential (or CHIP), which is an asymptomatic condition that increases the likelihood of leukemia and cardiovascular disease. He is studying 350 healthy World Trade Center responders and a group of historical controls from the literature.
He plans to use the results of his study to develop strategies to prevent these diseases in WTC responders.
In some of his WTC studies, Boffetta is working with Ben Luft, Director of the Stony Brook WTC Wellness Program at the Renaissance School of Medicine at SBU, who has been involved in providing extensive research and clinical support for WTC responders.
Boffetta is an “internationally renowned cancer epidemiologist” who contributed his “vast experience on the impact of environmental and occupational exposures [that were] seminal in our understanding of how the disaster of 9/11 would eventually lead to increased numbers of cancer cases among responders,” Luft wrote in an email.
Boffetta’s contribution and understanding will “transcend the events of 9/11 and its impact on the responder community to a general understanding of the increased incidence of cancer on Long Island,” said Luft.
While Boffetta has several academic affiliations with institutions including Harvard University, where he teaches a class for a week each year, and Vanderbilt University, his primary focus involves the work he conducts at Stony Brook and at the University of Bologna.
Boffetta plans to keep his research team considerably smaller than the 80 to 100 people who worked with him at the World Health Organization. Indeed, he said he mainly focuses on working with collaborators. He plans to hire his first post doctoral researchers soon.
As for teaching, Boffetta has been working with the program directors of the Masters of Public Health to develop a tract in epidemiology. He plans to start teaching next year.
Boffetta, who spoke with Times Beacon Record News Media through WhatsApp from Italy, said he often works double shifts to remain in contact with his colleagues in the United States and Europe. When he’s in the United States, meetings can start at 6 in the morning to connect with his European counterparts in the middle of their day. When he’s in Italy, his last meetings sometimes end at 11 p.m. or midnight.
Boffetta, however, said he has “a normal life,” which, prior to the pandemic, included trips to the opera and museums. He also enjoys skiing and hiking.
Married to Antonella Greco, who used to teach Italian, Boffetta lives in New York City. He has three daughters, who live in Brooklyn, Italy and Uruguay. He has been vaccinated against COVID-19 and is looking forward to the opportunity to interact with his colleagues in person once restrictions caused by the pandemic ease.
A few weeks ago, a Chicago White Sox player named Yermin Mercedes did what he was paid to do, hitting a ball far. His manager Tony La Russa was furious because his player broke an unwritten rule, swinging at a 3-0 pitch from an infielder for the Minnesota Twins when his team was already winning by 11 runs.
The next day, La Russa seemed fine with a Minnesota pitcher throwing a pitch behind the knees of Mercedes as punishment for a violation of that unwritten rule.
So, what are other possible random unwritten rules regarding life sportsmanship and what should the potential punishments be for violating those rules?
For starters, if you’ve lost a lot of weight, you don’t need to ask other people who clearly haven’t lost any weight, or perhaps have put on pandemic pounds, how they’re doing on their diet or if they’ve lost weight. They haven’t lost any weight. We know it, they know and you know it. You don’t need to contrast your success with their failure. The punishment for that kind of infraction should be that you have to eat an entire box of donuts or cookies in under a minute.
If you rescued a dog from the vet or the pound or from a box beneath a bridge in the middle of an urban war zone, you don’t need to ask where I got my overpriced and poorly trained dog. We get it: you did something great rescuing a dog, while those of us with designer dogs are struggling to get them to be quiet while we repeat the few answers we get right to the questions on “Jeopardy!” The punishment for such self-righteous dog ownership should be that you have to pick up the designer dog’s poop for a day. If you’ve been over virtuous, you also might have to compliment him on the excellent quality of his droppings and send other people a TikTok of your poop flattery.
If your kid just won the chess championship, you don’t need to wear a different T-shirt each day of the week that captures the moment of her triumph. The punishment for over bragging is that you have to wear a tee shirt that says, “Your kid is just as amazing as mine and certainly has better parents.”
If you’re in first class on a plane and you board first to sit in your larger, more comfortable seat, you don’t have to look away every time someone might make eye contact or, worse, through your fellow passengers. You aren’t obligated to look at everyone, but you can make periodic eye contact or provide a nod of recognition to the plebeians from group six. The punishment for such above-it-all behavior should be that you have to echo everything the flight attendant says as others board the plane, offering a chipper “good morning” or “welcome aboard.”
Finally, if you’ve taken a spectacular vacation, you don’t need to share every detail of your trip, from the type of alcohol you drank to the sweet smell of the ocean breeze to the sight of a baby bird hatching just outside your window. If you overdo the unsolicited details, you’ll have to listen to every mundane detail of the person’s life who was home doing his or her job while you were relaxing. Afterwards, you’ll have to take a test on his story. If you fail, you have to listen to more details, until you can pass.
Maybe Mr. La Russa has a point: unwritten rules could be a way to enforce life sportsmanship outside the lines.
Three-year medical school grads Adam Bindelglass, Simrat Dhawilal, William Guo, Maxwell Moore, Justin Bell, Eliana Fine and Brant Lai. Photo from Stony Brook University
Behind every stethoscope is a story.
Chineze Nwebube during the Graduate Address. Photo from Stony Brook University
This year, the stories among the new doctors who recently graduated from the Renaissance School of Medicine at Stony Brook University developed against the backdrop of a pandemic and included numerous firsts for the school and for the families of graduates.
Seven of the 150 graduates, which is the largest medical school class to earn a medical degree from Stony Brook, completed their training in three years, joining a small but growing trend among medical schools that are encouraging more people to consider becoming physicians while reducing the potential debt that can accrue while earning their medical degree.
“This year is really going to stand out,” said Andrew Wackett, vice dean of Undergraduate Medical Education and the director of the Clinical Simulation Center. “This was a group of students that really went through an awful lot. They rose to the occasion. They didn’t complain. Rather than do that, they tried to figure out how to help. It’s a special group of physicians that will make a great impact.”
Indeed, amid the worst of the pandemic, which hit Suffolk County especially hard during the spring of 2020, medical school students performed a host of important tasks, just as so many other health care professionals took on additional responsibilities and put themselves in harm’s way to protect the public.
Students volunteered to help with research, assisted patients who needed to connect with clinicians through in-person or telehealth and did “a lot of work with following up to make sure [residents] were doing okay when they were discharged,” Wackett said. These students were “really important in organizing the vaccine strategy,” as a number of them trained and volunteered to give vaccines. “They doled out thousands of them.”
Wackett suggested that the adversity caused by the pandemic has enabled class members to become resilient.
“What they learned, more than anything, was that they could adapt to whatever the world threw at them,” Wackett said. “It made them a much tougher group of students.”
Wackett said he was moved by the story of Chineze Nwebube, who described in the Graduate Address how she took the MCAT several times and had moments when she thought about giving up.
With the support of her family, she persisted and was “an exceptional medical student and will be an incredible physician,” Wackett wrote in an email.
Wackett said the spotlight on social injustice amid the pandemic also affected the dialog and the didactic efforts at the medical school.
“Certain populations have disparate health care, and we need to be involved to make that better,” Wackett said. That includes an analysis not just of disease or pathology, but also a consideration of how social factors impact the course of illnesses.
“Courses that traditionally taught science [are also] looking at the social context,” he said. “Medicine and public health are way more interconnected than we even realized.”
The graduates are preparing to venture into a world in which new lessons learned in the classroom and the clinic will prove especially valuable. At the same time, they bring a passion, dedication and conviction to the communities they plan to serve.
In between graduating and taking the next steps in their medical careers, some of this year’s graduates shared their inspiring and inspired stories.
Former dean and senior vice president of health services Ken Kaushansky, center, with Jheison and Monica Giraldo, the first married couple to enter and graduate from medical school at Stony Brook together. Photo from Stony Brook University.
Here comes the married couple
Monica Lenis didn’t think Jheison Giraldo, the guy from another class who was making up a lab in undergraduate biology at Stony Brook University, was all that funny. That just made him try so much harder, prompting eye rolls from a tough audience.
“His jokes were not making me laugh,” Monica recalled about that fateful science class eight years ago. “Somehow, we hit it off. We started talking after that and got to know each other.”
Despite Monica’s initial resistance to his charms, the couple started spending considerable time together, where they realized how much they had in common.
For starters, they were born in Colombia, five hours apart by car. Their families had moved to Long Island, his to Brentwood and hers to Bethpage, when each of them was nine years old.
Once they started to get to know each other, they appreciated each other’s strengths.
Jheison, who describes himself as the more outgoing of the two, tried to compete with Monica academically. That didn’t work out too well.
On a test in Biochemistry 2, in which the average was around 40, he reached the high 90s. He confidently went over to Monica, figuring he had to have beaten her.
She scored a 102, getting all the questions right and adding the two extra points.
“If you can’t beat them, join them,” he said. “I knew being next to her, she’s going to push me to excel in every way I could. I would do the same for her.”
Monica appreciated Jheison’s pervasive and persistent positive attitude. She also appreciated how well he interacted with her parents and her family, enjoying the older brother role he took with Monica’s 15-year-old brother.
After they graduated from Stony Brook, they got married. Jheison had always known he wanted to be a physician, dressing up for Halloween close to a dozen times as a doctor. Monica had other interests, including in the law. In addition to falling in love with Jheison, she also developed a deep appreciation for science in college and eventually deciding that she didn’t want to conduct research.
They applied to 30 medical schools. When they decided to go to Stony Brook together, they became the first married couple to enter the medical school together.
“When we first started” meeting people in the class, some of their peers “thought of us as the grown-up couple,” Monica said. Each of them, however, established their own academic and social friend groups.
While in medical school, they supported each other, as they focused on becoming, as Jheison put it, “the best physicians we could.”
Now that he is planning to become a resident in internal medicine and pediatrics and she plans to focus on internal medicine and cardiology, the medical couple has decided to contribute to a community they feel could use their support.
“From day one, we wanted to go to a place where we could be faced with patients who need more equity and diverse doctors working with them,” Jheison said. “We always looked at strong minority areas or historically under-represented areas. Miami stood out for us.”
While Long Island has been her home since she arrived in the United States in 2002 and has a “special place in my heart,” Monica is excited for an opportunity for personal growth. She is also thrilled to get away from the snow and the cold.
As she prepares for the next chapter in her life, she is looking forward to continuing in her journey with Jheison, who is “very positive and very uplifting. He’s always been very supportive, which is really all you could ask for in a partner.”
Eliana Fine with her husband Mark Feld, their 4-year-old son Ezra and their 6-month-old daughter Sophia. Photo from Eliana Fine.
Dr. Mom
Like many of her friends in the Orthodox Jewish community, Eliana Fine got married soon after high school, at the age of 19. Within two years, she gave birth to her son Ezra and, six months ago, to her daughter Sophia.
She could have dedicated herself and her time to becoming a stay-at-home mom, enveloping herself in a culture that emphasizes family and community and that keeps many women incredibly busy taking care of their often numerous children.
Instead, with the valuable and necessary support of her husband Mark Feld, Eliana decided to go a different route, not only pursuing a career as a doctor but also earning her degree in three years.
“I come from a community where most of the women don’t work,” Fine said. “I honestly didn’t even know any other orthodox Jewish woman who was a physician or was a medical student or physician trainee.”
Fine, however, wanted to develop her own career, particularly in the field of obstetrics and gynecology, where she felt she could help women, particularly in her community.
She described how the women in her community often don’t have extensive knowledge about reproductive and sexual health education before they get married. Women often have a kallah teacher, who is usually the wife of a rabbi.
“Your education is really based on the knowledge of your teacher,” Fine said, and “what they feel comfortable teaching you.”
Fine wanted to give back to her community, educating women about medical and health issues that can help “empower them to make better health care decisions.”
As a physician, Fine hopes to help other orthodox Jewish women understand more about women’s health and fertility.
“If women are having difficulty conceiving, the peer pressure can be stressful,” she said. “All of your friends are having kids and you’re not moving forward with your family.”
She wanted to give back to a community that she loves and that provides the context and framework for her life.
“There’s a lot of misconceptions when it comes to contraception,” Fine said. “People think contraception causes infertility. People don’t necessarily utilize contraception because of various misconceptions about it.”
To get to this point in her career, Fine said she had to overcome some of the expectations of a culture that sometimes places a stronger emphasis on family, particularly for women, than it does on developing careers.
She appreciated and is grateful for the support of her husband and her grandfather, Dr. Richard Fine, who was a dean of Stony Brook Medical School. When she was younger, she knew he was a physician, but wasn’t aware of his extensive career beyond that. She appreciated his regular questions to her about what she wanted to do when grew up, which allowed her to think for herself about what motivates her and how to make a difference in the world.
Fine believes that her experience and background as a member of the Orthodox Jewish community will help her relate to and communicate with her patients.
“Women have these family purity laws and it’s really important to go to an OB/Gyn who is very familiar with these laws. To be a part of the culture and come from the same community, you understand how to provide care.”
Fine, like several of her colleagues in the inaugural three-year medical program, felt closer to the incoming class of 2018 than to the graduating class of 2021, with whom she interacted primarily in the last six months of her medical school training.
During graduation, Fine appreciated the opportunities she feels she had that others don’t always get.
“I want to make sure I do something great with the opportunity I was given and make a difference in the world,” Fine said.
As for her children, Fine would like them to see that they, too, can choose how they live their lives, regardless of any expectations that others place on them.
“I would like to show my kids, if I can do it, they can do it,” she said. “I want them to know they have choices in life and that I will support whatever they choose. They should know they have the wings to fly, in terms of having a career and going to college.”
Adam Bindelglass. Photo from Stony Brook University
Early challenges
When Adam Bindelglass was five years old, the car he was in slid across black ice into oncoming traffic, which took the life of his two-year-old sister Amy.
Bindelglass also sustained serious injuries, breaking both his arms, his left leg, collar bone, and fracturing his neck. During his recovery, he had to wear a halo on his head to keep his spine aligned until it healed. The halo and the injuries left numerous scars, which triggered questions from his classmates.
“I have a pretty long scar from the base of my skull down my neck,” Bindelglass said. “I was self-conscious about those scars.”
Additionally, he has scars on his right bicep, and he has a mark that used to stretch the entire length of the long bone on his leg.
Motivated by the desire to help other people, particularly in difficult medical situations, Bindelglass said that day, and the scars he now bears as a mark of his career commitment, brought him to this landmark career moment.
A recent medical school graduate, Bindelglass said his experiences early in life have come up several times when he interacts with patients in high-stress situations in the hospital.
He recalled one incident when he spoke with a patient who was about to undergo spinal surgery.
He described how he could “live a full, fulfilling life without complications from these operations,” Bindelglass said. “I hope to continue to bring that [empathy], especially since the patients I’ll be working with [could be] in an acute situation where I’m going to see them right before one of the potentially the biggest operations or procedures of their life.”
He hopes to bring comfort and peace of mind going into surgery.
A three-year graduate from medical school, Bindelglass plans to continue in a residency at Stony Brook in anesthesia. Bindelglass said the pandemic showed him the importance of managing patients’ airways.
Bindelglass said he thinks about his sister “all the time” and hopes she “would be proud” of his commitment to helping others with his career choice.
Simrat Dhaliwal. Photo from Stony Brook University
The magic of threes
Simrat Dhaliwal graduated from Northeastern with her bachelor’s degree in neuroscience in three years and repeated the pattern at Stony Brook’s Renaissance School of Medicine, where she recently earned her medical degree.
The pattern of moving through degree programs in one fewer year is a by-product of several factors.
Dhaliwal is “efficient with time,” she said. “Medicine is a very long route. I know the path I want to take.”
Dhaliwal, whose mother Tejwinder Dhaliwal is a nurse practitioner at Rochester Regional and served as a health care role model, wanted to be a doctor from the time she was in kindergarten. As she attended middle school and high school, she became fascinated with science. She majored in neuroscience at Boston University.
Comparing the accelerated pace of her undergraduate years to medical school, Dhaliwal said the medical education is considerably more rigorous.
“As an undergraduate, once you finish a course, you can forget [some of the material] and move on,” she said. In medical school, students build “on the foundation. If you never had that strong foundation, there’s no way to move on. You’ll be responsible for patients” someday and “you need to know as much as possible.”
Indeed, the pandemic reinforced Dhaliwal’s decision to become a doctor, showing her that doctors had to “fall back on that foundation to help patients in need,” she said. “This pandemic made me want to become a physician even more because it is [a combination of] public service and critical thinking at the same time. There is no greater service to the public than helping someone, especially when it is in such high demand.”
Dhaliwal, who is starting her residency in internal medicine at Stony Brook on July 1, said her parents are originally from a rural part of India.
In her travels to visit family in India, she has “seen the health care disparity that exists in a non-developed nation.” For people in rural India, the nearest hospital is a 45-minute drive, which can create a dangerous delay for people who are having a heart problem or a stroke, where minutes can make the difference in a prognosis.
One of the most important lessons she learned from medical school is to keep learning. The same holds true for her expectations of herself when she practices medicine. She hopes to help educate people about how “preventive medicine is as important as treatment.”
From left, Shawn Serbin, Scott Giangrande and Chongai Kuang. Photo from Brookhaven National Laboratory
By Daniel Dunaief
Chongai Kuang is doing considerably more than standing in the middle of various fields throughout the southeast, looking up into the sky, sticking his finger in the air and taking notes on the potential appeal of the area.
Entrusted with finding the right spot for the third ARM Mobile Facility, or AMF3, Kuang, who is an Atmospheric Scientist in the Environmental & Climate Sciences Department at Brookhaven National Laboratory, is gathering considerable amounts of information about different areas in the southeast.
In March of 2023, the ARM3 mobile facility, which has been operating in Oliktok Point, Alaska, will have a new home, where it can gather information about atmospheric convection, land-atmosphere interactions and aerosol processes.
In addition to finding the right location for this facility, Kuang will coordinate with the larger science community to make recommendations to ARM for observations, measurements, instruments and sampling strategies. Observations from these fixed and mobile facilities will improve and inform earth system models.
Kuang would like to find a strategic place for the AMF3 that is “climactically relevant to provide important observations on clouds, aerosols, and land atmosphere interactions that are needed to answer science drivers” important in the southeastern United States, Kuang said. These facilities will help researchers understand how all these atmospheric phenomena interact with solar radiation and the Earth’s surface.
The AMF3 should provide information that informs climate, regional and weather models.
In 2018, the Department of Energy, which funds BNL and 16 other national laboratories, held a mobile facility workshop to determine where to move the AMF3. The group chose the Southeastern United States because it has atmospheric convection, high vegetative-driven emissions and strong coupling of the land surface with the atmosphere. This area also experiences severe weather including tornadoes and hurricanes, which have significant human and socioeconomic impacts, said Kuang.
The most violent weather in the area often “tests the existing infrastructure,” Kuang said. “This deployment can provide critical observations and data sets,” in conjunction with regional operational observational networks.
Atmospheric phenomena as a whole in the southeastern United States includes processes and interactions that span spatial scales ranging from nanometers to hundreds of kilometers and time scales spanning seconds to days.
Kuang’s primary research interests over the past decade has focused on aerosol processes at nanometer scales, as he has studied the kinds of miniature aerosol particles that form the nuclei for cloud formation. These aerosols affect cloud lifetime and spatial distribution.
“Our research is challenged by disparate scales relevant to phenomena we’re trying to characterize, from nanometers to the length scale of convective systems, which are tens of kilometers or even larger,” Kuang said. These scales also present opportunities to study coupled science with convection, aerosol and land-atmosphere interactions.
The ARM observatories around the world provide atmospheric observations of aerosols, clouds, precipitation and radiation to inform and improve Earth system models.
“We are going to leverage as much as we can of the existing networks,” Kuang said. The ARM has a fixed site in Oklahoma, which provides data for the Southern Great Plains Site, or SGP. The Southeastern site, wherever it winds up, will provide a context for large-scale atmospheric phenomena.
The way aerosols, clouds and weather systems form and change presents a challenge and an opportunity for research stations like AMF3, which will seek to connect phenomenon at spatial and time scales that affect where Kuang and his team hope to locate the site.
Kuang is also staying abreast of the latest technology and is also contributing to the development of these capabilities. The technology the AMF3 may use could be developed between now and when the site starts gathering data.
“We have the opportunity now to start thinking about what the next generation measurement capabilities and emerging technologies are that could be operational in 2023,” he said. “We are in conversations with the broader community and with different vendors and with a number of different investigators who are developing new technologies.”
Researchers hope to understand the coupling between the land surface and atmospheric phenomenon. “That will have feedback on radiation and precipitation and the impact on land-surface interactions,” Kuang explained. The current plan is for the new facility to operate for about five years.
While Kuang is focused on the scientific drivers for the site selection, he has also been exploring the dynamic with potential research partners, including universities, seeking ways to add educational partners.
“We have hopes and plans for this kind of deliberate, targeted outreach within the region,” Kuang said. “We want to organize activities like summer school, to provide young scientists with primers and an introduction about how observations are made within their backyard.”
The work he’s trying to do now is “setting the table and preparing the soil for the eventual siting” of the station.
Kuang will measure his success if the new site improves poorly represented model processes.
Once the DOE chooses a site, Kuang plans to develop and execute an initial science plan that uses AMF3 observations. As an ARM instrument mentor, he will also be responsible for a set of instruments that measure aerosol size and concentration.
A resident of Wading River, Kuang started working at BNL in 2009 as a postdoctoral researcher. When he’s not working, he describes cooking as “therapeutic,” as he and his wife, Anyi Hsueh, who is a psychiatric nurse practitioner, have explored Southeastern Asian and Middle Eastern cuisines.
Kuang is working with Associate Ecologist Shawn Serbin and Meteorologist Scott Giangrande, in site selection. The work presents an “important responsibility and our site science team envisions the AMF3 southeastern united States [site] to enable transformational science,” he said.
Working with the rideshare company Lyft, Suffolk County is offering free rides for senior citizens, veterans and people who are driving impaired to get their vaccinations for COVID-19 at county-run sites.
Starting on June 1, seniors who are over the age of 60, veterans and driving impaired residents can contact Suffolk 311 to schedule a pick-up and drop off to receive their inoculations.
The county would like residents to have an “equal ability to get their vaccines,” regardless of whether they have easy access to transportation, Suffolk County Executive Steve Bellone (D) said at a press conference announcing the program. “It’s not only good for them and their health: it’s good for all of us. It means that we will get closer to the numbers and the level of vaccinations we need to say that we have put this virus behind us.”
Suffolk County will be able to schedule and pay for the rides on behalf of residents, according to a Lyft spokeswoman.
The effort is a part of Lyft’s Universal Vaccine Access program, which started in December of 2020. Lyft has created more than 100 such partnerships and is facilitating access to rides throughout the country.
Lyft drivers will not wait outside while residents receive shots. County staff can arrange for pick up and drop off up to seven days in advance when residents call 311.
When seniors, veterans or driving impaired residents need transportation for their shots, county staff can request a ride using Lyft’s Concierge platform, which allows groups to request rides on behalf of those who may not have access to a smartphone or a bank account.
Bellone indicated that the county put out a competitive process to select a partner who could allow residents who don’t have access to a smartphone or who haven’t downloaded an app to secure a ride.
Lyft is committed to helping communities reach an “immunity that is going to get our economy back on track and our community back to normal,” Jen Hensley, head of government relations at Lyft said at the press conference.
Bellone shared his appreciation for the efforts of Senator Chuck Schumer (D).
“Without [Schumer’s] support, we wouldn’t be in a position to be able to offer a program like this,” Bellone said.
Vaccination efforts have helped reduce the spread of the virus, according to a recent interview with Gregson Pigott, commissioner of the Suffolk County Department of Health Services.
Lyft has also partnered with the White House.
From May 24 through July 4, anyone going to get their shots can get a ride code through the Lyft app or web site for two free rides during normal pharmacy hours of 6 a.m. until 8 p.m. of up to $15 each.
The county’s partnership with Lyft is the latest effort by Bellone to increase the number of people who have received the Pfizer, Moderna or Johnson & Johnson vaccines.
Through a “Lift Your Spirit, Take Your Shot” campaign, residents who are 21 years old and over and who receive their shot at a Suffolk County run site during the month of May will get a ticket that they can redeem at a participating brewery, winery and distillery for a free beer, tasting, glass of wine or cocktail.
Eight businesses are participating in that effort, including Del Vino Vineyards in Northport.
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