Health

Symptoms of OSA include loud snoring. Stock photo
Difficult-to-control high blood pressure may be a sign of OSA

By David Dunaief, M.D.

Dr. David Dunaief

Sleep is a crucial factor for our physical and mental health, yet many people struggle to get quality restful sleep. For those with obstructive sleep apnea (OSA), this occurs frequently and can lead to consequences more significant than exhaustion.

Sleep apnea is an abnormal pause in breathing that occurs at least five times an hour while sleeping and can be caused by either airway obstruction (OSA), brain signal failure (central sleep apnea), or a combination of these two (complex sleep apnea). There are a surprising number of people in the United States with sleep apnea. Its prevalence may be as high as 20 percent of the population (1). 

Here, our focus is on OSA, which can be classified as either mild, moderate or severe. It’s estimated that 80 percent of moderate and severe OSA are undiagnosed.

Risk factors for OSA include chronic nasal congestion, large neck circumference, excess weight or obesity, alcohol use, smoking and a family history. Not surprisingly, about two-thirds of OSA patients are overweight or obese. Smoking increases risk threefold, while nasal congestion increases risk twofold (2). Fortunately, many of the risk factors are modifiable.

Significant symptoms of OSA include daytime fatigue, loud snoring, breathing cessation observed by another, impaired concentration and morning headaches. These symptoms, while significant, are not the worst problems. OSA is also associated with a list of serious complications, such as cardiovascular disease, high blood pressure and cancer.

There are several treatments for OSA. Among them are continuous positive airway pressure (CPAP) devices; lifestyle modifications, including diet, exercise, smoking cessation and reduced alcohol intake; oral appliances; and some medications.

Cardiovascular disease

In an observational study, the risk of cardiovascular mortality increased in a linear fashion to the severity of OSA (3). In other words, in those with mild-to-moderate untreated sleep apnea, there was a 60 percent increased risk of death; and in the severe group, this risk jumped considerably, 250 percent. However, the good news is that treating patients with CPAP considerably decreased their risk by 81 percent for mild-to-moderate patients and 45 percent for severe OSA patients. This study involved 1,116 women over a six-year duration.

Not to leave out men, another observational study showed similar risks of cardiovascular disease with sleep apnea and benefits of CPAP treatment (4). There were more than 1,500 men in this study with a follow-up of 10 years. The authors concluded that severe sleep apnea increases the risk of nonfatal and fatal cardiovascular events, and CPAP was effective in stemming these occurrences.

In a third study, this time involving the elderly, OSA increased the risk of cardiovascular death in mild-to-moderate patients and in those with severe OSA 38 and 125 percent, respectively (5). But, just like in the previous studies, CPAP decreased the risk in both groups significantly. In the elderly, an increased risk of falls, cognitive decline and difficult-to-control high blood pressure may be signs of OSA.

Though all three studies were observational, it seems that OSA affects both genders and all ages when it comes to increased risk of cardiovascular disease and death, and CPAP may be effective in reducing these risks.

Cancer association

In sleep apnea patients under 65 years old, a study showed an increased risk of cancer (6). The authors believe that intermittent low levels of oxygen, which are caused by the many frequent short bouts of breathing cessation during sleep, may be responsible for the development of tumors and their subsequent growth.

The greater the percentage of time patients spend in hypoxia (low oxygen) at night, the greater the risk of cancer. So, for those patients with more than 12 percent low-oxygen levels at night, there is a twofold increased risk of cancer development, when compared to those with less than 1.2 percent low-oxygen levels.

Sexual function

It appears that erectile dysfunction may also be associated with OSA. CPAP may decrease the incidence of ED in these men. This was demonstrated in a small study involving 92 men with ED (7). The surprising aspect of this study was that, at baseline, the participants were overweight, not obese, on average and were young, at 45 years old. In those with mild OSA, the CPAP had a beneficial effect in over half of the men. For those with moderate and severe OSA, the effect was still significant, though not as robust, at 29 and 27 percent, respectively.

Dietary effect

Although CPAP can be quite effective, it may not be well tolerated by everyone. In some of my patients, their goal is to discontinue their CPAP. Diet may be an alternative to CPAP, or may be used in combination with CPAP.

In a small study, a low-energy diet showed positive results in potentially treating OSA. It makes sense, since weight loss is important. But even more impressively, almost 50 percent of those who followed this type of diet were able to discontinue CPAP (8). The results endured for at least one year. Patients studied were those who suffered from moderate-to-severe levels of sleep apnea. Low-energy diet implies a low-calorie approach, such as a diet that is plant-based and nutrient-rich.

The bottom line is that if you think you or someone else is suffering from sleep apnea, it is very important to go to a sleep lab to be evaluated, and then go to your doctor for a follow-up. Don’t suffer from sleep apnea and, more importantly, don’t let obstructive sleep apnea cause severe complications, possibly robbing you of more than sleep. There are effective treatments for this disorder, including diet and CPAP.

References:

(1) sleepapnea.org. (2) JAMA. 2004;291(16):2013. (3) Ann Intern Med. 2012 Jan 17;156(2):115-122. (4) Lancet. 2005 Mar 19-25;365(9464):1046-1053. (5) Am J Respir Crit Care Med. 2012;186(9):909-916. (6) Am J Respir Crit Care Med. 2012 Nov. 15. (7) APSS annual meeting: abstract No. 0574. (8) BMJ. 2011;342:d3017.

Dr. 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.     

New York Cancer & Blood Specialists in PJS.

Starting May 2, the Port Jefferson Station location of the New York Cancer & Blood Specialists will begin to offer COVID-19 testing to local fire and ambulance districts.

A spokesperson for the company said multiple local fire departments have committed to be the first groups tested at the site. It is reserved specifically for first responders only. The site will offer both antibody and nasal swab testing for COVID-19, and such results of this testing could also be useful in determining the utilization and allocation of personal protective equipment.

“We are trying to help the fire departments determine who can go back out into the field safely, whether or not members were previously exposed, if they’re not actively infected anymore, or if they have the antibodies so it’s safer for them to go into certain areas,” Diana Youngs, the vice president of clinical operations at NYCBS said in a release.

“Increased, reliable testing is going to be the key to reopening businesses, public facilities, and protecting our workers,” Brookhaven town Supervisor Ed Romaine (R) said in a release. “Offering these tests to our frontline workers is a critical first step.”

The location which is closed on weekends ensures no potential exposure to patients. Nurses in PPE will test the local fire and EMS volunteers at a designated drawing station in the parking lot. The results are processed within 30 minutes for the antibody test and between 18-24 hours for the nasal swab test.

“Volunteer ambulance workers on Long Island place themselves at risk of contracting this virus every day that they report for duty. Every single call they respond to is a potential COVID-19 positive patient,” said Greg Miglino,  the chief of South Country Ambulance. “We’re grateful to New York Cancer and Blood Specialists for offering testing to these volunteers, who put their lives on the line, not for pay, but to serve the most vulnerable people in our community.”

The location is at 1500 Route 112 Port Jefferson Station.

With a reduction of 77 hospitalizations in the last 24 hours from COVID-19, hospitalizations have dropped over 40 percent from their peak on April 10.

Indeed, the number of people in the hospital because of the coronavirus has dropped to 970, which is close to the number who were in Suffolk County hospitals at the start of April.

The end of the month of April “couldn’t be more different than when we started,” County Executive Steve Bellone (D) said on his daily conference call with reporters. “When we started [April], we had no idea whether that surge that we were talking about for so long would overwhelm” the health care system.

Bellone credited health care heroes with saving people’s lives and holding the line against the surge of people who developed symptoms from the disease.

The county is ending this month “in a far better place than we began,” Bellone added.

Even as hospitalizations have declined, however, residents are continuing to test positive for the virus, as the number of new positive tests increased by 723 to 34,802.

Ever since the county created hotspot testing, the numbers from those seven sites, which now includes Southampton, have been increasing. The county has tested 2,459 people and has positive results on 881 of the 1,868 tests for which results are known.

The number of people with coronavirus in Intensive Care Unit beds also fell by 25 to 344.

Bed capacity is approaching 70 percent, which is the target rate to reopen the economy.

Bellone is also optimistic that the county will continue to move towards the Center for Disease Control and Prevention’s target of 14 straight days of declining hospitalizations from the virus. Once the county reaches that level, it can consider reopening the economy.

In the last 24 hours, 114 residents have left the hospital.

Deaths due to complications from the coronavirus continue to climb. The number of people who died in the last day from the virus was 22, bringing the total to 1,177 people.

Bellone said he doesn’t think there’s a resident of Suffolk County who hasn’t been impacted or know someone who lost a family member, friend or loved one to the disease. The county executive mourned the loss of Terri Freda, who worked in the Medical Examiner’s Office. Freda, who was a spokeswoman for the Suffolk County Medical Examiner’s office in 1997 after the crash of TWA Flight 800, and her husband both lost their battle with the virus.

“Our thoughts and prayers are with Terri’s family,” Bellone said.

The county will begin testing law enforcement this Monday and will administer 500 tests at Suffolk County Police Academy. Officers can register starting tomorrow.

Separately, Stony Brook University is urging residents with medical needs unrelated to COVID-19 to reach out to their doctors. People who are having cardiac issues or strokes need rapid-response medical attention, the hospital said.

In a press release, Stony Brook indicated that it has taken numerous steps to protect patients and minimize exposure to COVID-19, including: preventing crowding; adopting CDC guidelines about social distancing and protective equipment; ensuring that staff, doctors and patients are wearing masks; sanitizing facilities; and screening patients the day before their visits. Patients with symptoms of the virus are going to offices designated for COVID-19 care.

Suffolk's own data shows areas with large numbers of black and latino populations have been impacted greatly by the ongoing pandemic. Photo screenshot from Suffolk data map

Black and Latino communities have been disproportionately impacted by the coronavirus pandemic, and on Long Island where communities are as segregated as they are, much of it comes down to geography.

COVID-19 cases in Suffolk County have an identifiable curve. Data on maps provided by Suffolk County show a darkening red on a path rolling from the eastern end of the Island toward the west, homing in on the western center of the Island — Wyandanch, Brentwood and Huntington Station. In such areas, data also shows, is also where many minority communities live.

Suffolk County health services commissioner Gregson Pigott shares COVID facts in Spanish online April 8. Photo from Facebook video

Data from New York State’s Department of Health maps shows the coronavirus has disproportionately harmed black and Latino communities. Brentwood in particular has shown 3,473 cases, or nearly 55 per 1,000 persons. New York State Education Department data shows the Brentwood school district, as just an example, is nearly 85 percent Latino and almost 10 percent black. Huntington Station, another example of a location with large black and Latino populations, has just over 1,000 cases, or 33 persons per 1,00 have the virus. As testing continues, those numbers continue to grow.

Though data showing the numbers of COVID-19 deaths is out of date, numbers from New York’s Covid tracker website show the percent of black residents who died from the virus was 12 percent, higher than the 8 percent share of the overall Suffolk population. For Latino residents, the fatality percent was 14 percent, lower than their population of 19 percent.

While whites make up 81 percent of the population, their proportion of residents confirmed with the virus is only 64 percent. If the white population were suffering the same proportionate death ratio higher than their overall population, then dozens more white people would have already perished from COVID-19.

“I’m not surprised by the information given,” said Brookhaven town Councilwoman Valerie Cartright (D-Port Jefferson Station). “We need to be testing as much as possible, we need to be tracing, we need to make sure once we get that under control, we need to make sure people get treated.”

The COVID Hot Zones

Toward the beginning of April, Suffolk County established three “hot spot” testing centers in Wyandanch, Brentwood and Huntington. Those sites quickly established a higher rate of positive cases compared to the county’s other sites, especially the testing center at Stony Brook University. A little more than a week ago, such hot spot sites were showing 53 percent of those tested were positive. On Tuesday, April 29, that number dropped slightly to 48 percent hot spot positive tests compared to 38 percent for the rest of the county.

Though such testing centers didn’t arrive until more than a month into the crisis, county leadership said plans for such sites developed as data slowly showed where peak cases were. 

“When we started working with the IT department to find the addresses where these cases were, Southold was leading,” said Dr. Gregson Pigott, the Suffolk Department of Health Services commissioner. “Then Huntington Station became the hot spot. Then Brentwood became the leader in cases, and to this day Brentwood has the most cases.”

Suffolk County has also started plans for recovery after things finally start to open up. The Recovery Task Force is being headed by multiple partners, including Vanessa Baird Streeter, an assistant deputy county executive.

The task force will need to provide aid, but Suffolk County Executive Steve Bellone (D) said there needs to be emphasis on addressing the glaring inequities, and put an emphasis on “coming back stronger.”

“There’s no question the issue is we know there have been disparities,” he said. “The crisis like this is only going to exacerbate those issues and have those disparities grow.”

But as it became clear to officials the virus was greatly impacting the majority of minority communities harder than others, said communities were watching day by day how the virus was upending lives, infecting whole households and leaving many without any chance of providing for their families.

Latino Community During Coronavirus

Martha Maffei, the executive director for Latino and immigrant advocacy group SEPA Mujer, said Latino communities are hit so hard especially because of many people’s employment. Either they were effectively let go, or they are working in jobs that if they tried to take time off, they would be out of a job. Instead, such workers, even in what has already been deemed “nonessential business,” are still going to work even in places where workers have already gotten sick.

“We were receiving calls of jobs they know the workplace has been infected, they continue to ask employees to come to work,” she said. “They don’t have the option to say no, because they’re basically forcing them and they don’t want to lose their jobs.”

A survey conducted by the Pew Research Center in early April found approximately 41 percent of Latinos have lost their jobs since the start of the pandemic, compared to just 24 percent white and 32 blacks being laid off or furloughed. This jives with research showing about 50 percent of people on the lower income scale have either lost their job or had to take a pay cut.

Many who relied on their jobs to support their families have now lost them completely, and since many are undocumented, they have no access to any kind of federal assistance. In homes that are often multigenerational and cramped, workers out on the front lines come home and have very little means of sequestering themselves.

SEPA Mujer shows their support for immigrants by donning yellow bracelets. File photo by Sara-Megan Walsh

SEPA Mujer also advocates for women in violent domestic situations, and Maffei said its crisis hotline phone has been ringing daily. Bellone has told reporters the incidents of domestic violence are up 3.5 percent from early to mid April.

At issue is the immigrant community’s trust in local government and law enforcement, and that same government’s ability to get the life-saving and virus-mitigating information to them.

The hot spot testing centers now include Spanish-speaking translators, at least one per each, according to Pigott. Bellone also announced, working with nonprofits Island Harvest and Long Island Cares, they are providing food assistance to visitors at the testing sites. Brentwood is already seeing those activities, and Wyandanch will also start providing food April 30.

When the first hot spot site opened in Huntington Station, Maffei said she had clients who were struggling to schedule an appointment. Though she suspects it has gotten better with more sites opening up in western Suffolk, true help to the community should come in the form of facilitating access to information. 

“We’re trying to do the best we can, but a lot of people don’t have access to the internet, don’t have Facebook,” Maffei said. 

Pigott related the county is providing multi-language information via their website and brochures at the testing sites, but community advocates argue there is a demand for such details of where people can get tested and how they can prevent infection, straight into the hands of people, possibly through mailings or other mass outreach.

Why Minority Communities are Vulnerable

Medical and social scientists, in asking the first and likely most important question, “why?” said the historic inequities in majority minority populations are only exacerbated by the SARS-CoV-2 virus. 

Dr. Johanna Martinez, a physician with Northwell, is in the midst of helping conduct a research project to work out the variables that are leading to how the pandemic has deepened and exacerbated existing inequities.

“It’s not something biological that is different between black and Latino people. It really is the historical inequities, like racism, that has led to the patients being marginalized,” Martinez said. “It is most closely linked to social determinants.”

The links are plain, she said, in socioeconomic status, and perhaps most importantly, one’s access to health care. Immigrant communities are especially likely to lack insurance and easy communication with doctors. It’s hard for one to know if one’s symptoms should necessitate a hospital visit if one also doesn’t have a doctor within phone’s reach. It also means an increased spread of the virus and a potential increased load on hospitals.

“If you’re uninsured, the place where you’re going to get health care from is the emergency room,” the Northwell doctor said. “Right now, we’re trying to use telemedicine, but if you don’t have an established primary care doctor, you don’t have the ability to speak to the doctor of the symptoms you’re having and if this is something you can stay home for or go to the hospital.”

Current data released by New York State has mostly been determining age, as its well-known vulnerable people include the elderly, but Martinez’ data is adjusting for other things like comorbidities. Data shows that diabetes, hypertension and obesity put one at a higher risk for COVID-19-related death, and studies have shown poorer or communities of people of color are at higher risk for such diseases. 

“It’s almost like a double whammy,” she said. “It’s something that makes them even more vulnerable to a very serious disease.”

“It’s not something biological that is different between black and Latino people. It really is the historical inequities, like racism, that has led to the patients being marginalized.”

— Dr. Johanna Martinez

Housing is also a factor. Once one leaves the hospital, or on recommendation from a doctor, it’s easy to tell people who are showing symptoms to isolate a certain part of the house, but for a large family living in a relatively small space, that might just be impossible.

Whether Suffolk’s numbers detailing the number of confirmed COVID patients is accurate, Martinez said she doubts it, especially looking at nationally. Newsday recently reported, upon looking at towns’ death certificates compared to New York’s details on fatalities, there could be many more COVID deaths than currently thought.

“We need more testing to see the prevalence in certain communities,” she said.

Cartright, who works as a civil rights attorney, said these factors are what the government should be looking at as the initial wave of COVID-19 patients overall declines.

“We know black people are dying at a disproportionate rate,” she said. “We need to look at how many people are living in the same household, how many people actually have health care, how many are undocumented who were scared of going to the emergency room. There are so many factors we need to be able to take a look at.” 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Gianna Pellela and her family volunteering for those in need. Photo from Pellala

It goes without saying that these are difficult times and many things going on that we have never witnessed before. Many articles and news stories appear daily about some pretty bad things going on. However, the focus of this article will be to look at some of the positive things we are seeing; from the eyes ofboth the young and old.

An Intro

By Andrew Harris

Recently, I have seen so many things going on on during this crisis that I haven’t seen in many years. Some of these happenings have been positive, and I wanted to take the time to stop and point some of them out. The first thing I noticed was something that used to be more common, but I have not heard in many years. It was the sounds of playful laughter of young children outside in their backyards almost on a daily basis. I started to notice more and more positive things that are going on and wanted to focus on these things and see if some of our students might see some positivity for a younger persons perspective. I was impressed by what they were noticing, like how helping others helps to take any negative focus off yourself, how young people are staying connected and supporting each other and finally how our environment seems to be improving on a daily basis.

Helping Others

By Gianna Pellela

Gianna Pellela and her family helped collect items for those in need. Photo from Pallela

In this time of crisis, it can be very easy to focus on the negatives in our lives. My family and I have tried to find ways to both occupy ourselves and help others even though we can’t physically see too many people. Being able to focus on the positives makes this quarantined time a lot easier. The situation we are in can really be a good time of self reflection and personal improvement. It can also be used to be a time of unity amongst all of our communities.

While I have done many things to keep up with my own well being, I have also helped in a food drive. This food drive was held at the cafe owned by my church. Throughout the week, the community dropped off food and supplies that all got disinfected. My family and I went to the cafe where we were alone, and we divided these foods and supplies into bags for the community members in need. We also filled bags for nurses and medical workers. These bags had items such as bonnets, masks, waters and more. Then, people drove through the parking lot one at a time and opened their trunks so that we could place the bags into their cars. This was an amazing event that allowed me to give back even considering the circumstances.

Unity in Distance
By Daniela Galvez-Cepeda

Despite the fact that physical contact has been cut off from us during the quarantine, it is important to remember that we are not alone. Through different social media apps and discussion boards, high school seniors are communicating with others about an array of topics.

I have experienced this first hand. Along with my Student Government co-president, we figured it was important to let our whole community know the talent the Comsewogue Class of 2020 holds. That is why we created the @wogue.2020 Instagram page, which posts pictures of seniors and the colleges they are going to. Classmates “liking” and “commenting” on each other’s posts really shows that we can still be connected despite the distance.

Not only are our Comsewogue seniors interacting online with one another, but they are also meeting the people they will go to college with. Since campus tours and visits aren’t available right now, colleges have created special channels for their incoming students to learn about the school they are going to. Students can send a quick text or email to an upperclassman or dean knowing that they will get a response in a matter of minutes. I, personally, have been connected with so many current students and future classmates from my college that it has made my decision to go there so much easier.

These cases show that, even though we are going through some rough times, we can still find alternative ways to build new relationships and make new lifelong connections.

Noticing the Improvements in Our Environment

By Ashley Doxey and Alyssa Morturano

Since it started, the Coronavirus outbreak has devastated most of the world. On Dec. 31, 2019, the government in Wuhan, China, confirmed that health authorities were treating dozens of cases. Since then, there have been outbreaks in 210 countries and almost 200,000 deaths. But the outbreak is also having an intriguing impact on Earth’s environment, as nations restrict the movement of people.

The Coronavirus has halted tourism. Since the lack of boat traffic, the Venice canals are thriving andare clear enough to see the fish swimming below. This lack of boat traffic has allowed for fish, like mosquito fish, to roam the canals. There is still a lack of water purity, but all of the sediment has settled to the bottom. Even swans and dolphins have been spotted in the nearby port. Now, the canal is filled with tiny fish, scuttling crabs, and an array of multicoloured plants.

Since the Coronavirus outbreak, the arrival of fish in Venice isn’t the only improvement this world has seen. People are using less oil, and carbon dioxide and nitrogen dioxide emissions are falling too. This leads to better air quality. More animals are roaming the empty city streets. The coronaviruspandemic is terrible, but in this time of hardship, we must look at the positives. These environmental benefits are another reason for us to stay indoors.

These are some of the positive things we are seeing from the current situation. Focusing on helping others helps us not be so self-centered and only concerned with ourselves. Learning new ways to connect with others, even virtually, can be positive and even when things get back to normal may help us make new and more connections. Finally, we are all breathing in cleaner air and seeing new environmental improvements all around us.

Perhaps this can remind us to turn off the television, stop watching all the negativity and start seeing and creating more positive things out of all of this.

Family, My Silver Lining

Derek Order

Quarantine. Who would have ever thought at any point in my life I’d be held to a quarantine. I have only heard of quarantines in movies and television. No friends. No girlfriend. No trip to Europe. No gym. My senior fashion show was cancelled, and both my graduation and senior prom are to be determined. Unbelievable.

From the beginning, my mom has told me to try to find the silver lining. There is always a silver lining?  How could there be a silver lining when my senior year is ruined? I am going to college in the fall, and this is how I am going to spend my last few months; quarantined with my family?

And then it occurred to me. Family is my silver lining. I have spent these two months with the most important people in the world. My mom has taught me to cook. I’ve spent countless hours in Monopoly tournaments with my brothers. I caught up on some classic television with my Dad. Entering this quarantine, I thought it would be miserable, but it is not. It is actually a blessing.

Outro: An Adendum

By Andrew Harris

The students who wrote this article did so completely voluntarily and out of the goodness of their own hearts. The additional writing they do is purely on their own and not part of their normal heavy and challenging workload. They continue to impress me during these challenging times. All people are hit hard with what we are going through, but as a student the new normal has changed dramatically. Learning online can be extremely difficult to navigate. Having your sports, graduation and all your in-person socialization cancelled, as a teenager, is difficult to say the least. I applaud them.

Stock photo

If the trend continues through Monday, Suffolk County will be within the U.S. Centers for Disease Control and Prevention’s guidelines for reopening the economy.

Additionally, the county’s hospitalization rate is also around Gov. Andrew Cuomo’s (D) targeted 70 percent or lower goal, creating health care flexibility in the event of an increase in the incidence of COVID-19.

With Cuomo’s New York Pause set to end on May 15, County Executive Steve Bellone (D) said he would continue to discuss ways to restart part of the local economy.

“We are looking at a number of different guideposts for how we reopen and when it makes sense to reopen,” Bellone said on his daily conference call with reporters.

Bellone hopes to have contract tracing and sufficient testing in place to reopen the economy in a safe way. Another target is to keep the rate of transmission per infected individual below one.

“If that gets to 1.1, we are looking at this virus spreading once again,” Bellone said. A worst case scenario would be if the government reopened the economy and then needed to reinstate restrictions, which would cause emotional, psychological and economic devastation, the county executive said.

Bellone indicated that a summer working group, led by Deputy County Executive Jon Kaiman, would likely have guidelines as early as next week for beaches, pools and other facilities.

The summer is “going to be different,” Bellone said. “It’s not back to where we were.”

The number of people infected over the last day continued to rise, climbing 661 to 34,079.

The number of residents in Suffolk County hospitals fell by 35 to 1,047, while the number of people in the Intensive Care Unit also declined 35, to 369.

With hospitals at 74 percent capacity and ICU beds at 69 percent, the county is “right around the numbers where the state says you need to be to reopen the economy in a safe way,” Bellone said.

The number of people who left the hospital rose by 111.

The death rate from complications related to coronavirus continued to climb, as 24 people died over the last day, bringing the total deaths to 1,155.

Separately, Bellone, U.S. Rep. Lee Zeldin (R-NY-1) and former National Football League player Gary Brown will host a discussion for veterans tomorrow night at 5:30 p.m. People who would like to listen to the town hall can tune in on facebook live, at facebook.com/SteveBellone.

The six hotspot testing sites had conducted close to 3,000 tests, with 818 positive tests amid the 1,741 with results. That rate is 47 percent, which is slightly lower than yesterday, but still well above the 37 percent for other testing locations. As Bellone announced yesterday, the county is opening another hotspot in Southampton tomorrow.

Bellone said his office has now distributed over 3 million pieces of personal protective equipment. He thanked federal and state governments for their delivery of supplies, which included 600,000 ear loop masks, 843,000 gloves and 42,000 face shields over the last day.

The county executive highlighted the recent donation of 50,000 surgical masks by the Greater New York Automobile Dealer’s Association, which is a part of the association’s effort to distribute half a million surgical masks to counties in the downstate area.

In the Suffolk County Police Department, 86 officers have tested positive and 72 have returned to work.

Members of Stony Brook's medical team throw fists in the air during todays flyover by the Blue Angels and Thunderbirds. Photo by Kyle Barr

After a public effort to gain access to short term funds, County Executive Steve Bellone (D) last night received word that the pleas had paid off.

Members of the non-invasive cardiology department at Stony Brook University Hospital. Photo by Kyle Barr

The Federal Reserve expanded the eligibility requirements in the federal CARES Act to counties that were below the previous threshold of two million residents to provide short term borrowing through a municipal liquidity fund.

“This is a huge short in the arm to our efforts to provide property tax relief to people who have been negatively impacted economically,” Bellone said on his daily conference call with reporters.

The funds will allow the county to access short term borrowing for up to 36 months and will relieve the financial burden that comes from the Suffolk County Tax Act, which prevents the county from receiving funds until the middle of the year. During periods when Suffolk collects typical tax revenue, when residents can enjoy local restaurants, movies, and concerts, the urgency to access funds at a reasonable rate isn’t as high.

“This gives the county the ability to do short-term borrowing to address the cash flow issues that are caused by revenue almost completely drying up because of the wholesale shutdown of certain parts of our economy,” Bellone said.

The County thanked numerous area politicians, including U.S. Sen. Chuck Schumer (D) and U.S. Rep. Lee Zeldin (R-NY-1).

Schumer “walked the letter into [Secretary of the Treasury Steve Mnuchin’s] office and said, ‘We need to do this,’” Bellone said. “Zeldin lobbied [President Donald Trump (R)] and [Mnuchin] directly. He set up a call with Mnuchin and himself so I could make the case directly about why Suffolk County needs this and why this is so important.”

In the meantime, hospitalizations continue to decline, sustaining a trend that could lead to a measured and gradual reopening of the economy.

The number of hospitalizations declined by 15 to 1,082, with the number of residents in the Intensive Care Unit falling by four to 408.

These declines are getting close to the Centers of Disease Control and Prevention recommendations for 14 days, which is the minimum for restarting and reopening the economy.

Gov. Andrew Cuomo (D) said today there has to be ground rules for such a reopening. Hospitals, he said, must be at no more than 70 percent capacity with a rate of transmission no higher than 1.1.

An additional 44 people left the hospital in the last day.

People are still dying from complications related to COVID-19 at a rate that is greater than one per hour, as 29 people died over the last day, bringing the total to 1,131.

In terms of hotspot areas, the six sites have now tested 2,124 people. The county has results for 1,584, with 757 of those confirmed positive. The rate of positive tests is 48 percent, which is still well above the rate of 38 percent for the rest of the county, but is below the initial testing rate of 53 percent.

The county plans to open a seventh testing site on Thursday in Southampton.

Working with Long Island Cares and Island Harvest, the county has also started providing food to people who come to select hotspot testing sites, starting with Brentwood. On Thursday, Wyandanch will also provide food distribution to those receiving a coronavirus test who also need food.

Bellone urged people who are having food security issues to contact 311. Operators will connect residents with agencies that can provide food.

Separately, campgrounds will be closed in line with state guidance through May 31, when the county will revisit the issue. Anyone who has a reservation between April 1 and May 31 will receive a refund.

“Stay tuned as we move forward in May,” Bellone urged those interested in the camp sites.

The Suffolk County Police Department continues to be “fortunate” with the overall rate of COVID-19 infection, as 86 sworn officers have tested positive, with 71 returning to work, Commissioner Geraldine Hart said on the call. Hart attributed the lower rate of infection to the procedures the police department followed early on once the infection reached the shores of Suffolk County.

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After police announced Monday, April 27 several incidents of tense armed standoffs between police and residents, County Executive Steve Bellone (D) cited increased levels of domestic violence and the need to combat it while people remain stuck at home.

Police said Mark Reyes, 51, allegedly entered the home of a female acquaintance Saturday, April 25, in Kings Park. Police said she received knife wounds during the incident where she was assaulted. After the woman escaped the next day, the man would eventually be arrested after a prolonged standoff between him and police.

Bellone said the ongoing crisis has created a “climate” for people in situations with domestic violence, “increasing the risks they are facing.”

The county executive said police has seen an uptick in domestic violence incidents of 3.5 percent from April 3 through 16. 

The current crisis, where more people are at home without any means of visiting other places or seeking help, has intensified the issue.

“Domestic violence is horrific and intolerable,” Bellone said, also citing numerous services people can use if they are in such a domestic situation. Because many in such situations cannot pick up the phone to call for help, they can reach New York State’s Office for the Prevention of Domestic Violence by texting 844-997-2121 or visiting opdv.ny.gov. Bellone said people can also reach out to Suffolk through 311 to get a list of resources, or visit suffolkcountyny.gov/crime-hotline. Suffolk also has the Hauppauge-based DASH Center that offers crisis care for children and adults. They can be reached at 631-952-3333. 

“We know this climate is absolutely conducive to exacerbating mental health challenges that were there prior to the crisis unfolding – we want people to know those resources are available,” he said.

While the county executive said the vast majority of people have adhered to social distancing, there have been cases where people haven’t abided. Police said officers have done 870 checks of non-social distancing since New York Pause began, and they have found 76 violations. In addition, 86 officers have tested positive for COVID-19 and 70 are back at work. That’s up from 81 who tested positive April 17, according to police data.

Meanwhile, with questions about how New York State will be able to reopen, more testing and research has resulted in showing more people have been infected with COVID-19 than originally thought. Gov. Andrew Cuomo (D) announced today close to 15 percent of New Yorkers actually have the virus. Long Island specifically shows 14.4 percent of people have the virus, according to results from the state survey. 

This has only placed new importance on county and state-level testing initiatives. Bellone said there are plans to expand the number of hot spot testing sites within the county, but did not go over details of where those could be located. He also said there are plans to expand the operations of testing sites in spots Brentwood and Huntington Station, which have already seen a higher percentage of people testing positive for COVID-19 compared to sites like Stony Brook University.

He said he supported such “diagnostic testing” initiatives such as Cuomo’s announced plans for testing kits being available at pharmacies. As both counties and states in the region work out the details for eventually gradually reopening the state, such tests and the data they receive from them will be invaluable. 

The county executive added after speaking with the Army Corps. of Engineers, the Gov. plans to keep the field hospital located at Stony Brook University in place for the time being. Worries that the virus could come back in a resurgence later in the year, the so-called “second wave,” is weighing heavy on officials’ minds.

The move from Sunday to Monday saw a general increase in the number of COVID-positive cases rise 464 to 33,286 in Suffolk. While Saturday saw a bump in the number of hospitalizations, this day’s numbers saw the overall declining trend continue with a decrease of 37 bringing the total down to 1,097. ICU beds have also opened up thanks to the discharges by 35, bringing the total number of people in ICU beds to 408. 

Hospital capacity is sitting at 3,369, while ICU beds are at 775. 953 hospital beds and 228 ICU beds are available. There have been 69 people who have left hospitals, recuperating enough to continue recovering at home.

With that, the number of deaths continues to rise, with 32 people dying in Suffolk from COVID-19, bringing the total deaths to 1,102.

With additional reporting by Daniel Dunaief

METRO photo

The pace at which people are leaving hospitals in Suffolk County continues to be higher than the rate at which residents are entering, easing the burden on health care workers and on a system pushed close to capacity two weeks ago.

Over the last day, the number of people in hospitals from complications related to Covid-19 declined by 41 to 1,134.

“That’s still a very big number, but is much lower than its peak level,” County Executive Steve Bellone (D) said on his daily conference call with reporters.

The number of people who are using Intensive Care Unit beds fell by 10 to 443.

At the same time, 109 residents have been discharged from the hospital.

“We wish them a speedy, continued recovery,” Bellone said.

Meanwhile, Gov. Andrew Cuomo announced the initial preliminary plans for reopening the state. Phase 1, he said, would include opening it up for construction and manufacturing with “low risk.” Phase 2 would include a matrix of other nonessential businesses. There would be a two-week period in between each phase to monitor the effects. It would also be in coordination with surrounding states.

No large places that would facilitate gathering would open during that time of transition, the governor said. The first businesses to reopen would likely be upstate, which has seen much less impact than the downstate counties have seen.

Suffolk County delivered another 210,000 pieces of personal protective equipment yesterday. The county also received supplies from the Federal Emergency Management Agency, which include 7,100 gloves, 800 face shields, 5,000 surgical masks, hundreds of protective suits, hand sanitizer, Clorox wipes and ice packs.

Bellone offered his thanks to Rep. Lee Zeldin (R-NY-1) on delivering personal protective equipment.

The county executive also highlighted the United Way Covid19 Fund, which provides support to people in need who have lost their jobs or have been furloughed. People interested in seeking support from the fund can go to UnitedWayLI.org.

Bellone highlighted the rescue efforts of Matthew Honce of East Patchogue, who pulled a Medford man who was treading water out of Bellport Bay on Saturday. The man had been treading water for 15 minutes when Honce pulled him out.

“I want to say a big thank you to a good samaritan, who is a great example of the kind of people we have in this county,” Bellone said. “What could have been a tragedy [wasn’t]” thanks to Honce and the Suffolk County Marine Bureau.