Frustrated with large crowds congregating outside restaurants and bars in Manhattan and the Hamptons, New York State Gov. Andrew Cuomo (D) warned that these areas could face greater restrictions while businesses could be fined or could lose their state-approved liquor licenses.
People have made over 25,000 complaints to the state about a lack of social distancing and limited face coverings in Manhattan and the Hamptons.
Suffolk County Executive Steve Bellone (D) said he hadn’t heard of any increase in reports of noncompliance in the Hamptons and emphasized the different states of reopening between the two regions.
“The Hamptons are in a little bit of a different situation than Manhattan,” Bellone said on his daily conference call with reporters. “We are in Phase,” in which restaurants can offer outdoor dining, while Manhattan just entered the first phase of reopening, which doesn’t include such outdoor dining accommodations.
The Suffolk County Police Department has been educating businesses that weren’t open before throughout the area about the rules they have to follow.
“Businesses are happy to reopen and they want to follow the rules,” Suffolk County Police Chief Stuart Cameron said on the call. “They don’t want the rollback, either. We are working collaboratively and will be in touch with East End chiefs” to assist them in ensuring any compliance.
Bellone reiterated that he is “confident we have been doing compliance and enforcement from the beginning.”
The numbers related to COVID-19 for Suffolk County continue to remain positive.
Over the last day, 44 people have tested positive for the virus, bringing the total to 4,243. Those numbers continue to hover on a daily basis below the targeted 100 for the county.
While he continues to monitor the number of daily positive results closely, Bellone said he believes that the protests didn’t cause a spread of the virus if the new infections remain at this level through the middle of the week.
Being outside and wearing face coverings helps reduce the transmission of the virus.
Meanwhile, the number of people hospitalized with COVID-19 remained the same through the day ending on June 12 at 125. The number of people in Intensive Care Unit beds rose by one to 40.
Hospital bed capacity remains below targets. An additional 16 people were discharged from the hospital in the last day.
The number of people who died from complications related to the virus increased by one to 1,948.
Protesters rallied in Rocky Point Friday, June 12 in calling for an end to police brutality, and even to a complete restructuring of law enforcement. Photo by Kyle Barr
As the days pass between near daily protests related to the killing of Minneapolis resident George Floyd by a former police officer charged with his murder, the number of positive tests for COVID-19 remains at low levels.
In the last day, the number of positive tests was 56 as the county tested 5,879 people for a 1 percent rate for positive tests.
“My guess is that you’re not going to see a spike [in positive tests for the virus] as a result of the lack of social distancing in protests,” County Executive Steve Bellone (D) said on his daily conference call with reporters. “I do believe if you have those face coverings on outdoors, that is very safe.”
After the county entered Phase Two of its reopening this past Wednesday, Bellone hopes to expedite the process of moving to Phase Three.
“We thought the most relevant comparison would be to communities upstate where there are dense populations around the cities, to see whether they had impacts in Phase TWo and compare those and provide that information,” Bellone said. Based on what he has seen from the numbers in other areas, he doesn’t see any cautionary signs elsewhere.
As for the viral numbers in the county, Bellone said they continue to move in a favorable direction.
The number of people in the hospital with COVID-19 declined by nine in the day ending on June 11, bringing the total to 125. The number of people in the Intensive Care Unit also declined, with two people leaving the ICU, bringing that total to 39.
Bed capacity remains comfortably below targeted levels, with 65 percent of hospital beds occupied and 55 percent of ICU beds occupied, both of which are below the 70 percent target.
An additional 18 people were discharged from the hospital in the last day.
Meanwhile, the number of people killed by complications related to COVID-19 increased by 2 to 1,947. This follows a day in which the number of people who died from complications related to the virus was zero for the first time since mid March.
Meanwhile, the county will continue to maintain a field hospital built by the U.S. Army Corps. of Engineers at Stony Brook University in the event that a second wave hits in the fall. If such an increase in viral cases hits Long Island at the same time as a difficult flu season, that could have a “devastating” impact on the health of the residents and the economy, Bellone said.
The county has not had to use that field hospital yet. If that facility, however, becomes necessary in the fall and into the winter, the county will add any necessary winterizing capacity.
Bellone continued to urge the federal government to help local governments, like Suffolk County, as they deal with the economic fallout from the virus. Bellone cited a municipal finance team’s report that estimated an economic hole that could be between $1.1 billion and $1.5 billion.
“We know we are in a recession right now,” Bellone said. “The numbers are cataclysmic in their impacts on local governments.”
Public health, public safety, and social services will all be “critical” in the days and months ahead, which will put tremendous strain on a county budget that depends on sales taxes that completely dried up after the county followed federal guidelines and shut down businesses to save lives and contain the spread of the virus.
“The good news is that our federal representatives are fighting for us in Washington to make sure the national government has done what it has always done throughout our history in times of need,” Bellone said.
The county executive said Long Island sends billions more to Washington than it receives each year, which increases the importance of helping Long Island’s economy recover.
Many Illnesses Carried by Ticks Share Symptoms with COVID-19
A deer tick is a common type of tick on Long Island. Stock photo
With summer close by and as New York State continues to relax shutdown restrictions, residents will naturally want to get some fresh air. But while open spaces like parks and nature preserves provide a temporary reprieve from the COVID-19 pandemic, they are also home to ticks. These arachnids can carry Lyme disease and other serious tick-borne illnesses. Experts say this is the time when ticks are most active and when their numbers increase.
“We have already passed a month of tick activity here on Long Island,” said Jorge Benach, distinguished Toll professor of Molecular Genetics & Microbiology and Pathology at the Renaissance School of Medicine, Stony Brook University. “With minimal contact because people were staying indoors due to the pandemic, we have seen less cases.”
Benach said that could change in the coming summer months, especially with an already large tick count this year. Currently, we are entering the second phase of tick season, which is when the arachnids are in the nymph stage and are harder to spot.
“For some reason Long Island has a heavy population of ticks,” Benach said. “It has the perfect environment for them and they really thrive.”
Three species of ticks call Long Island home. The deer tick can carry Lyme disease, anaplasmosis and other illnesses, while American dog tick can carry Rocky Mountain spotted fever. The lone star tick can transmit tularemia and ehrlichiosis.
“The lone star tick, we believe, is the most aggressive of the three species, and we didn’t know it existed until 1980,” the distinguished professor said. “And then it somehow found its way to Long Island.”
A 2019 study, headed by Benach and Rafal Tokarz, assistant professor of epidemiology at Columbia University, with co-authors from SBU and Columbia, found prevalence of multiple agents capable of causing human disease that are present in three species of ticks in Long Island.
Another concern this season is that tick-borne illnesses like Lyme disease and anaplasmosis have symptoms that overlap with those of COVID-19, including fever, muscle aches and respiratory failure, but without persistent coughing.
“It is true that they have overlap in the initial symptoms, but once you get past that first stage it should be easier to diagnose if that person has a tick-borne illness,” Benach said.
Tick-borne diseases are usually treated with antibiotics. The effects range from mild symptoms that can be treated at home to severe infections that if left untreated can lead to death in rare cases.
The distinguished professor stressed the need for people to be aware of ticks when they are in certain areas outdoors.
Repellents and wearing long-sleeve pants and shirts can be good deterrents for ticks. Other tips include walking along the center of trails, washing and drying clothing when you come home and keeping pets from areas that could be tick infested.
Benach said there is a misconception that humans get ticks from dogs. Instead, it is more likely one gets a tick from being in the same space as your dog.
“You should be checking yourself, and if you spot a tick get it off as soon as possible,” he said. “If you develop any symptoms or illness contact your doctor.”
In a milestone indicative of how deadly and prolonged the toll of the virus has been, Suffolk County reported the first day without a death from COVID-19 since March 16.
“I’m finally able to say that no one in Suffolk County in the last 24 hours has died from COVID-19,” County Executive Steve Bellone (D) said on his daily conference call with reporters. “That’s a great place to be.”
While Bellone said the county, which entered Phase Two of its reopening Wednesday, June 10, still has a ways to go before it controls the spread of a virus that has claimed the lives of 1,945 people in the county, the day without a death from the pandemic is a “milestone.”
With many other states, including Texas and North Carolina, are experiencing a surge in the number of people diagnosed with the virus and being admitted to hospitals for their care, Suffolk County continues to experience a decline in the number of residents testing positive.
Indeed, in the last day, despite protests over the death of Minneapolis resident George Floyd at the hands of a former police officer charged with murder, the number of people who tested positive in the county only increased by 47, raising the total to 40,559.
Bellone attributed the current condition on Long Island to the pain, uncertainty and suffering that rocked Long Island, which was the epicenter of the pandemic in the country.
“Because of the experience we’ve gone through, overwhelmingly, people are taking precautions,” Bellone said. “They are still listening to the guidance. Even at protests, even at demonstrations, I have seen people wearing face coverings.”
Suffolk County also has an advanced testing and contact tracing system that is making a difference as the area reopens.
Meanwhile, earlier today, Governor Andrew Cuomo (D) signed an executive order requiring local police agencies to develop a plan that reinvents and modernizes police strategies and programs in their community based on community input. Each police agency’s plan must include procedures and practices that extend beyond the use of force by April 1, 2021.
The police forces have to engage the public in the process, present a plan for comments, and share that plan with a local legislative body. If the government doesn’t certify the plan, the police may not be eligible to receive future state funding.
Bellone said he “looks forward to working with the state” on community police policies. The county executive said he is proud of the work the Suffolk County Police Department has done with anti-bias training.
The SCPD has “developed leading edge initiatives.”
Cuomo also signed a bill passed by the state senate earlier this week repealing 50-a, a statue in civil law that prevented people from accessing records of police and other civil servants like firefighters. Advocates said this will allow more transparency, especially regarding police misconduct. Police unions and senate republicans said this would puts cops in more danger, despite proponents saying people cannot gain access to cops’ personal information.
Bellone reemphasized a point he has made in recent days amid the backlash against unjust and unfair policing polices, suggesting that the police are “part of the community, they aren’t coming into the community” from the outside.
Police Commissioner Geraldine Hart said she met this morning at 11 a.m. with the President of the Guardians, which is an internal fraternal organization representing black officers. She meets with the Guardians on a monthly basis.
Officers in the Guardian “know they have accessibility to leadership,” Hart said. “Those conversations lead to suggestions.”
The discussion this morning was more informal and was part of an open conversation and dialog.
As for the impact of COVID-19 in the county, the numbers continue to show a hard-fought recovery from the deadly virus.
Hospitalizations in the 24 hours ending on June 10 declined by 17 to 134. The number of residents in the Intensive Care Unit also declined by four to 41.
“These are all great numbers,” Bellone said.
An additional 16 people were discharged from hospitals in the county.
The bed capacity remained below important levels. Residents with COVID-19 represented 66 percent of the overall beds, and below 60 percent of the ICU beds, which are below the 70 percent guidance offered by the Centers for Disease Control and Prevention.
The county handed out 17,000 pieces of personal protective equipment over the last day.
Finally, the county worked with Island Harvest to distribute food through a program called Nourish New York today.
The effort, which was at the Westfield South Shore Mall in Bay Shore, planned to distribute 100,000 pounds of food, including cheese, milk, yogurt, fresh fruit and vegetables and ground beef.
The program “helps those in this desperate time who need food” while preventing waste and supporting the agricultural community, Bellone said. Through 2 p.m., the program had handed out more than 2,500 boxes of food items.
New York may have started Phase One of its reopening and other states may have reopened shops and businesses, but life won’t change much for Angie Tempio.
A native of Commack who had been working at the front desk at Funt Orthodontics in Setauket since 2017, Tempio received a heart transplant last summer and plans to do everything she can to protect herself amid threats from the pandemic.
Tempio, who was preparing to rebuild her life outside of an apartment she shares in Yaphank with her boyfriend James O’Brien, plans to remain as isolated as possible, lowering the chance of contracting COVID-19.
Angie Tempio with her boyfriend James O’Brien
“The world is opening back up,” Tempio said. “For me, it’s not. Nothing will change for a few months. I’m used to being left behind.”
Tempio, however, doesn’t feel sorry for herself or rue her situation. She now focuses on new possibilities.
Diagnosed with restrictive cardiomyopathy when she was 11, she slowly went into heart failure. She struggled for a few years before her transplant, but the last year was the toughest. She said her pacemaker kept her alive.
Tempio, who recently turned 26, had made her peace with death, particularly when she struggled to walk two steps at a time and when her failing heart beat only 30 times per minute. “I was lucky,” she said. Two months after she went on the transplant list, she “got the call, which is a miracle in itself.”
While Tempio feels overwhelmingly blessed that she can consider having children, she said she is also sensitive to the over 1,870 residents who died from COVID-19 in Suffolk County.
Tempio had a rare heart condition that caused her to be a small statistic. Even with the overall mortality rate for COVID-19 below one percent, she empathizes with people and their family who are on the other side of those small numbers.
“Experiencing being a small statistic has definitely made me look at things differently,” she said. “In my head, anyone can [be such a statistic] and most people aren’t realizing that and that’s what’s making me overly cautious.”
Tempio said she was a gymnast and was seemingly healthy before she developed the rare heart disease.
“Although I haven’t experienced the virus itself, I’ve been through the same obstacles,” she explained in an email.
Even when the coronavirus first started infecting people on Long Island, Tempio wore masks to the classes she is taking at Suffolk County Community College, where she hopes to study to become a transplant coordinator. She said she felt judgment from people who thought she was being overly concerned about the virus.
“Most people didn’t realize” how much more vulnerable she was to the virus than the typical person walking around Long Island, she said.
While she’s waiting for the moment when she can emerge from a home cocoon, Tempio has been connecting with a network of friends and a close-knit heart transplant support group. She and 13 others are a part of a group that shares a profound and unique experience that brings them together and helps them connect with, and support.
“They have been my outlet during one of the hardest times in my life and I am so grateful to have them,” she said.
Tempio said she feels a responsibility to live her best and healthiest life. She believes she is “now living for my donor,” she said, and plans to “take the best care of this heart that I can.”
Dr. Frank Darras, Clinical Professor of Urology and Clinical/ Medical Director of the Renal Transplantation Program at Stony Brook University Renaissance School of Medicine Hospital, has performed over 1,700 kidney transplants since 1990.
This year has been especially challenging for the surgeon, as he has had to enhance safety procedures to protect patients who are on immunosuppressants during the COVID-19 pandemic.
As part of the new normal for kidney transplants, Stony Brook takes time to test patients for coronavirus. In the first few weeks after the virus hit Suffolk County, the tests took all day. In recent weeks, the labs have produced test results within one to three hours.
Through late April, Darras said the hospital hasn’t had to send anyone home who had a positive COVID-19 test.
The long-term effects of COVID-19 on the function of normal kidneys is difficult to predict, he said. Many of the patients with the most severe symptoms from the virus not only needed ventilators, but also needed dialysis treatments. In the majority of cases where people recovered from the virus, their kidneys also recovered.
The hospital has also seen patients who received kidney transplants who have contracted the virus. “Several of these [transplanted patients] had diminished function, but all of them recovered their kidney function,” Darras said.
The longer-term effects of the virus are unknown. Some patients who were severely ill may have recovered, but have kidney problems that slowly escalate over time.
“I would not be surprised to see that happen, whether that’s months or years down the road,” Darras said.
Another unknown is how the virus would affect the transplant community in the longer term. “In the worst case, it’ll make our living donor pool smaller,” he said. About one out of three kidney transplants comes from a living donor. “On the other hand, in the best case scenario, [the virus will have] relatively little impact. It’s too early to tell,” he added.
According to Darras, people who need kidney transplants can extend their life expectancy by two to three times. He estimated that about five to six percent of the people waiting for a transplant died while on a kidney waiting list.
Darras explained that “time is of the essence” for many patients because the “longer patients are on dialysis, the more urgent [the need] to get them transplanted,” and added that finding donors is critically important, particularly during the pandemic.
“There is a concern about trying to make sure that we can get enough kidneys,” he said. “Our job and the job of LiveonNY is to raise awareness about organ donation.”
Yolanda Reed-Anthony took this selfie 15 minutes before her transplant.
By Daniel Dunaief
Yolanda Reed-Anthony’s grandparents, Dr. Frank Darras, and an anonymous donor likely saved the life of this devoted wife, mother, and daughter.
In the midst of the COVID-19 pandemic, which forced Governor Andrew Cuomo (D) to shut down most of New York’s economy and limit hospital activities to emergency procedures, Reed-Anthony had an unusual dream. In the dream her late grandparents, William and Rose Evans, brought her a white box. When she opened it, multicolored butterflies fluttered around her.
Intrigued by the dream, Reed-Anthony read that it suggested a new transition in life.
Sure enough, later that day, the Holbrook resident received the kind of call her brother Richard Reed, Jr. and her father, Richard Reed had gotten for themselves: a kidney was available, thanks to an anonymous donor who was a match for her.
The family has struggled with a kidney condition known as focal segmental glomerulosclerosis (FSGS), which necessitates the use of dialysis at least twice a week.
The timing for Reed-Anthony made the decision about whether to accept the incredibly rare gift of a new organ problematic. “The thought” of passing up the kidney on March 12, in the midst of the pandemic “crossed my mind, but I quickly dismissed it because of the dream,” she said in a recent interview.
Yolanda Reed-Anthony with her brother Richard Jr. after his kidney transplant in January.
Reed-Anthony entered Stony Brook University Hospital, where Dr. Frank Darras, the Clinical Professor of Urology and Clinical/ Medical Director of the Renal Transplantation Program at Stony Brook Renaissance School of Medicine, awaited, along with a transplant team.
As Suffolk County became an epicenter for infections, with the number of sick in hospital and Intensive Care Unit beds increasing, people in need of organs faced increasingly difficult odds of finding a life-saving organ.
For starters, every person who became sick or died from COVID-19 was immediately ineligible to be a donor. Without effective treatment or a cure for the virus, the transplantation of an organ from an infected person into someone who needed the organ but likely couldn’t survive the infection raised the risk of such an operation above the benefits of the procedure.
The immunosuppressant drugs each organ recipient takes after the operation reduces the likelihood that the person will reject the organ. These drugs also, however, raise the chance that an infection of any kind, much less a lethal virus, would threaten the health and life of the recipient.
Reed-Anthony said the Stony Brook staff let her know that the hospital process would be different even than for her brother, who received his kidney in January.
The doctors and nurses made sure no one who wasn’t supposed to be in her room entered. “They were like secret service for me,” Reed-Anthony said. “They took precautions for me that were different than for my brother and father,” adding that she was well aware of the viral struggle that so many others in the hospital were enduring at the same time. She was in the hospital for five days by herself, with no visitors other than the medical staff.
Reed-Anthony said the staff was ad-libbing in the precautions they took with her, minimizing the risks during her period of extreme vulnerability. Several days after surgery she needed to walk, which is something her brother and father did up and down the hospital hallway. She never left her room, circling from the bed to the window to the bathroom at least six times.
Yolanda Reed-Anthony with her father Richard after his kidney transplant.
The social workers, meanwhile, stood by the door to ask questions, while the dietician wasn’t allowed in the room, with the nurses bringing the food tray in and out of the room.
Dr. Darras, who performed the surgeries for Yolanda, her father and brother, explained that the transplant team understood and appreciated the extreme demands COVID-19 placed on Stony Brook University Hospital and on the health care system throughout Long Island.
“We knew we had to work within the framework of the administration and the hospital to try to do what we needed to do for our patients without infringing on the big picture,” Darras said. “We knew we had to be good team players because every department had to have a redeployment of staff into other areas of the hospital.” Still, within the unprecedented needs of the rest of the hospital, the transplant team still felt like they could do what they needed safely for patients working against the unkind ticking of a clock.
While it took significant effort to find safe areas for the transplant group to use, Darras and other surgeons performed life-enhancing and saving surgeries in the midst of the COVID-19 firestorm.
Indeed, Darras led one of the transplants at 3:30 am on a Saturday night, when so many of the staff might otherwise have been sleeping, relaxing or stepping away from the intense health care drama that surrounds them. The mood in the room, however, was positive.
“Everybody that was involved felt that it was a really happy moment,” Darras said. “You couldn’t have found a happier group of people.”
The health care workers appreciated the opportunity to use their training towards a positive outcome. “Out of being in the fire, something good was happening,” said Darras. “It was a happy surgery. It gave people a reprieve and they wanted to do this again.”
Darras appreciates the heroic efforts of so many of his colleagues, who have done yeoman’s work in the face of the pandemic. He also believes the efforts of the transplant teams were heroic in taking care of patients who had life-altering surgeries in a unique environment.
At the same time that doctors and support staffs found safe places for these procedures, LiveOnNY, which is the nonprofit organ procurement organization for New York City, Long Island, Westchester and the lower Hudson Valley, has struggled to find donors during the pandemic.
For starters, everyone who contracted the virus became ineligible to donate an organ. Even those people who had filled out organ donor cards couldn’t save or extend the lives of others if they had the disease. “With so many deaths related to COVID, the potential for organ donation has been drastically reduced,” Helen Irving, the CEO of LiveOnNY said. In January and February, LiveOnNY was involved with 51 organs donations each month. In March, that number surged to 67. In April, as New York reached its viral peak, the number of organ donations fell to 10.
While Stony Brook University Hospital performed organ transplants during the pandemic, other donation programs slowed or stopped due to the virus. That is starting to normalize now, according to LiveOnNY.
Irving said the reduction in the ability to perform these operations is “quite devastating.” She has been acutely aware of the hospital deaths during the pandemic. New York State law requires hospitals to call any death into the organ procurement organization. At one point, LiveOnNY was receiving over 600 calls each day, when the normal number is closer to 150.
Additionally, with people avoiding the hospitals, even when they might have life-threatening conditions, the potential for organ donation also declines.
In normal times, LiveOnNY receives about 12 referrals per day from cardiac arrests or strokes. During the peak of the pandemic in early April, they averaged four. “If someone dies at home, there is no potential there to be an organ donor,” Irving said, although they can become a tissue donor.
Through the pandemic, Irving suggested that LiveOnNY will continue to search for the needle in a haystack that saves or extends someone’s life. The nonprofit is a part of a network that extends across a wider geographic area beyond New York. The group is part of 58 organ procurement organizations nationwide.
Irving encouraged New Yorkers to sign up to become donors, particularly in a post-COVID world. Typically, she would be making the case for signing up to become organ donors through community events. At this point, however, most of those events are no longer being held because of limitations on large gatherings.
“We have to educate the community that needs to know that organ donation is still possible,” Irving said. “Patients can’t wait on a transplant list. That message is far more important today than ever before. You can save someone’s life by signing up on the registry.”
People who would like to sign up can do so through the LiveonNY.org web site, by calling (866) NY-DONOR (693-6667) or through [email protected].
Organ donations were “always a miracle to begin with,” Irving said. “Now we’re asking for a bigger miracle.”
Reed-Anthony has signed up to be an organ donor herself. She is prepared to donate any organ a recipient might need. After all she and her kidneys have been through, she suggested those organs might not be the best choice.
Dr. Kenneth Kaushansky, the dean of the Stony Brook Renaissance School of Medicine at Stony Brook University, is eager to restart the educational mission of training medical school students.
Dr. Kenneth Kaushansky, the dean of the medical school at SBU, said there’s a real possibility of a second wave of COVID-19. File photo
While Gov. Andrew Cuomo (D) has said that medical schools can restart on June 22, Kaushansky has asked for a waiver to allow students to continue to build on their clinical knowledge sooner.
“I was worried about the delay in doing the experiential learning,” Kaushansky said. A delay that lasts too long could push graduation back for the rising fourth year students, which is “not good for any health care professional. We need health care professionals, including respiratory therapists, physical therapists, nurses and social workers” among others.
On top of the need to ensure on-time graduation for the Class of 2021, he said another wave of the COVID-19 crisis will increase the demand for graduates.
The medical school dean said Stony Brook University Hospital is watching carefully the protests over the death of Minneapolis resident George Floyd at the hands of a police officer charged with his murder. The hospital and staff are ready in the event of a spike in demand for health care after large gatherings on Long Island and in New York City.
“We are ready to mobilize on a moment’s notice because we did it the first” time, albeit with numerous questions about the course and potential treatment for the new virus, Kaushansky said.
On Saturday, he sent out a letter to the health sciences community addressing what he termed “health care racism.”
“We witnessed the sum of all these effects in the disproportionate lethal burden of COVID-19 on communities of color, a combination of overcrowding at home, of jobs that do not allow the protection afforded by work from home, or from the disproportionate burden of health care conditions that arise, in part, from health care disparities,” he wrote in the letter. He urged the Stony Brook community to “do everything in our power to work toward erasing the social determinants of disease that contribute to our unequal society.”
He urged learners and critical staff to develop and practice cultural sensitivities, and he also suggested that the school should make “certain our graduates reflect the diverse society in which we live.”
In its admission decisions, SBU includes the notion of overcoming hardship as a part of the process through which the school evaluates prospective students.
In the coming years, Kaushansky plans to emphasize further the importance of encouraging those who have faced significant hurdles in applying to the medical school.
In terms of treating patients who have COVID-19, he is encouraged by the use of remdesivir and convalescent plasma. The school has these treatments available for people who are sick and is studying the effectiveness of these approaches.
More than 1,500 patients have been admitted through the university hospital, Southampton and Eastern Long Island hospitals and have benefited from the clinical study of symptoms including clots.
Surgeons had noticed that D-dimer levels, which are proteins that indicate the presence of clots, were shooting up. They decided when this protein reached a certain level, they would use a full dose of anticoagulants.
Stony Brook has put the results of these aggressive anticoagulant treatments into an article that has been submitted for publication.
In the meantime, the university has taken an across-the-board approach to raising anticoagulants.
“That will improve the mortality rate should we get a second wave,” Kaushansky predicted.
In the event of a second wave, Stony Brook Hospital and, indeed, New York will be better prepared, with more tests, greater awareness and contact tracing.
Kaushansky believes that the people who have already fought off the virus are presumably immune from getting it a second time. What’s unclear, he explained, is whether the antibody test is predictive of resistance. Additionally, it’s unclear how long that resistance will last.
He expects that monoclonal antibodies can work, but that they should be reserved for the sickest patients. They are expensive and are hard to produce the level necessary for the U.S. population of more than 300 million people.
What worries the Stony Brook dean is that people have had enough of staying at home, social distancing and wearing masks. In the worst of the crisis, when the numbers of people sick and dying were climbing, Kaushansky could get to work in much less time than normal, as traffic on the roads had lightened up considerably.
Days before the Phase 2 reopening, which began on Wednesday of this week, the level of traffic has returned to a more normal density.
Meanwhile, Phase 2 for Stony Brook University involves reopening research laboratories and allowing people who were previously deemed nonessential workers to return to the labs in an “orderly and safe fashion,” Kaushansky said.
The university has installed plexiglass shields, requires social distancing, built partitions between people who don’t have their own offices, and requires everyone to wear masks and have their temperatures taken when they come to work.
The hospital opened up for elective surgery two weeks ago. Everyone who is scheduled for surgery has to get a viral swab the day before.
The approach the university has taken in requiring personal protective equipment and social distancing has paid off for hospital staff who have been exposed to all those sick patients. The rate of antibody tests of employees is much lower than in the general community.
“It’s safer to be a frontline health worker at Stony Brook than to work at some grocery stories,” Kaushansky said.
On the clinical side, he believes Stony Brook Hospital needs more highly skilled nurses. At the peak, the university hospital had 437 patients. If it had reached 500, “we would have been in trouble,” he added.
Upstate New York had sent 20 experienced nurses to help out.
“Nursing is important and high-level nursing, operating-room nursing, was particularly stressed,” Kaushansky said. “We need to hire more nurses.”
He added that the school trains excellent nurses and plans to hire some of its own graduates.
In terms of medical school classes, the dean said the university hasn’t decided yet whether to bring small groups back together. The big lecture halls will still involve remote teaching.
“Are the smaller group educational exercises going to be back safely?” he asked. “I’m working to make that happen.”
Kaushansky takes solace in the way PPE reduced the infection rate for the hospital as a whole, and believes such an approach could work for medical school classes as well.
Even as Phase Two of the economic restart began yesterday, County Executive Steve Bellone (D) said he has reached out to Governor Andrew Cuomo’s (D) office to request the restart of other activities.
Bellone has asked that youth sports be permitted. He said he also would like to see non-touch museums that have large spaces with capacity limits reopen.
“Some of that was lumped into Phase Four with mass gathering-type activities,” said Bellone on his daily conference call with reporters. The county is looking at what it can open up sooner.
Bellone, who spent parts of the first day of Phase Two getting a haircut, dining out and enjoying ice cream with a tour of several downtowns in Suffolk, said the reopening was “off to a good start” and that it helped people feel more of a sense of normalcy.
Bellone reminded business owners that the county started a personal protective equipment giveaway.
The county is providing some cloth face coverings and hand sanitizer to small businesses, nonprofit companies and faith based organizations.
“Reopening businesses in this environment is a challenge,” Bellone said. “To the extent we can do something that helps them a little bit, we want to do this.”
Bellone said 403 businesses had filled out applications for those supplies since Monday and that 226 businesses had picked up those kits. Interested business owners can find a supply request form at suffolkcountyny.gov/bru.
Viral Numbers
Over the last 24 hours, an additional 48 people have tested positive for COVID-19, which brings the total to 40,512. The county executive hopes that number continues to remain below 100 for any given day.
The number of new infection numbers continues to remain below 100 despite protests in response to the murder of Minneapolis resident George Floyd.
Bellone said it might still be a little early to draw any conclusions about the potential spread of the virus in response to the protests. He will be looking more closely at the new infection rates through the weekend and into the beginning of next week.
“My sense is that being outdoors is a safe environment,” the county executive said.
For the 24 hour period ending on June 9, the number of people in hospitals with COVID-19 declined by 14 to 151. The number of people in Intensive Care Units declined by one to 45.
Hospital bed occupancy from people with the coronavirus stood at 66 percent for hospital beds overall and at 60 percent for ICU beds.
An additional 15 people were discharged from the hospital and are continuing their recovery from the virus at home.
Meanwhile, the number of people who died from complications related to COVID-19 increased by four in the last day. The total for the same period ending yesterday was two, which brings the total to 1,945.
The county distributed an additional 26 pieces of personal protective equipment over the last day.
As a general goal, aim for at least 30 minutes of moderate physical activity every day. METRO photo
Low inflammation may play asignificant role in healthy aging
By David Dunaief, M.D.
Dr. David Dunaief
What does it mean to you to “grow old gracefully?” For people I speak with, it means to be independent, mobile, mentally alert, and not burdened by chronic illnesses. In other words, to maintain a good quality of life.
The number of 90-year-olds is growing by leaps and bounds. According to the National Institutes of Health, those who were more than 90 years old increased by 2.5 times over a 30-year period from 1980 to 2010 (1). This group is among what researchers refer to as the “oldest-old,” which includes those aged 85 and older.
What do these people have in common? According to one study, they tend to have fewer chronic morbidities or diseases. Thus, they tend to have a better quality of life with a greater physical functioning and mental acuity (2).
In a study of centenarians, genetics played a significant role. Characteristics of this group were that they tended to be healthy and then die rapidly, without prolonged suffering (3).
Factors that predict one’s ability to reach this exclusive club may involve both genetics and life-style choices. Let’s look at the research.
Exercise
We are told time and time again to exercise. But how much do we need, and how can we get the best quality? In a 2014 study, the results showed that 5 to 10 minutes of daily running, regardless of the pace, can have a significant impact on life span by decreasing cardiovascular mortality and all-cause mortality (4).
Amazingly, even if participants ran fewer than six miles per week at a pace slower than 10-minute miles, and even if they ran only one to two days a week, there was still a decrease in mortality compared to nonrunners. Here is the kicker: Those who ran for this very short amount of time potentially added three years to their life span. There were 55,137 participants ranging in age from 18 to 100 years old.
An accompanying editorial to this study noted that more than 50 percent of people in the United States do not meet the current recommendation of at least 30 minutes of moderate exercise per day (5).
Diet
A long-standing paradigm has been that we need to eat sufficient animal protein. However, cracks have developed in this theory, especially as it relates to longevity. In an observational study using NHANES III data, results show that those who ate a high-protein diet (greater than 20 percent from protein) had a twofold increased risk of all-cause mortality, a four-times increased risk of cancer mortality and a four-times increased risk of dying from diabetes (6). This was over a considerable duration of 18 years and involved almost 7,000 participants ranging in age at the start of the study from 50 to 65.
However, this did not hold true if the protein source was plants. In fact, a high-protein plant diet may reduce the risks, not increase them. The reason, according to the authors, is that animal protein may increase insulin growth factor-1 and growth hormones that have detrimental effects on the body.
Interestingly, those who are over age 65 may benefit from more animal protein in reducing the risk of cancer. However, there was a significantly increased risk of diabetes mortality across all age groups eating a high animal protein diet. The researchers therefore concluded that lower animal protein may be wise at least during middle age.
The Adventists Health Study 2 trial reinforced this data. It looked at Seventh-day Adventists, a group that emphasizes a plant-based diet, and found that those who ate animal protein up to once a week had a significantly reduced risk of dying over the next six years compared to those who were more frequent meat eaters (7). This was an observational trial with over 73,000 participants and a median age of 57 years old.
Inflammation
In the Whitehall II study, a specific marker for inflammation was measured, interleukin-6. The study showed that higher levels did not bode well for participants’ longevity (8). In fact, if participants had elevated IL-6 (>2.0 ng/L) at both baseline and at the end of the 10-year follow-up period, their probability of healthy aging decreased by almost half.
The takeaway from this study is that IL-6 is a relatively common biomarker for inflammation that can be measured with a simple blood test offered by most major laboratories. This study involved 3,044 participants over the age of 35 who did not have a stroke, heart attack or cancer at the beginning of the study.
The bottom line is that, although genetics are important for longevity, so too are lifestyle choices. A small amount of exercise, specifically running, can lead to a substantial increase in healthy life span.
Protein from plants may trump protein from animal sources in reducing the risk of mortality from all causes, from diabetes and from heart disease. This does not necessarily mean that one needs to be a vegetarian to see the benefits. IL-6 may be a useful marker for inflammation, which could help predict healthy or unhealthy outcomes. Therefore, why not have a discussion with your doctor about testing to see if you have an elevated IL-6? Lifestyle modifications may be able to reduce these levels.
References:
(1) nia.nih.gov. (2) J Am Geriatr Soc. 2009;57:432-440. (3) Future of Genomic Medicine (FoGM) VII. Presented March 7, 2014. (4) J Am Coll Cardiol. 2014;64:472-481. (5) J Am Coll Cardiol. 2014;64:482-484. (6) Cell Metab. 2014;19:407-417. (7) JAMA Intern Med. 2013;173:1230-1238. (8) CMAJ. 2013;185:E763-E770.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
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