Health

Richard Hoey’s son Kevin lives in a Central Islip residential home, and he said its high time facilities like his son’s receives targeted testing. Photo from Hoey

Port Jefferson resident Richard Hoey’s son Kevin lives in a Central Islip residential home for the developmentally disabled. Kevin is diagnosed as intellectually disabled with Down syndrome, autism, behavioral disorders and is developmentally delayed. His mobility is confined to a wheelchair. Due to the ongoing coronavirus pandemic, 21-year-old Kevin has been largely confined to the facility. Family has only been able to communicate with their son via video chat, in which Hoey said Kevin’s attention span is “minimal.” 

“Kids in residential homes, they are all not able to protect themselves.”

— Richard Hoey

“Look to see him, he doesn’t recognize inside that little square TV screen,” Hoey said.

The issue, the parent said, is simply not knowing. Though he said the facility, Eaton Knolls, one run by United Cerebral Palsy of Long Island, has largely been communicative of current goings-on, two staff and one resident have tested positive for the virus. Though staff has been wearing personal protective equipment, they have been “low on the totem pole” in receiving masks and gloves.

“Kids in residential homes, they are all not able to protect themselves,” Hoey said. “They have no idea the dangers with sneezing, coughing or licking things. And they’ll never have any idea about it.”

The Port Jeff resident and his family have created a Change.org petition saying that Gov. Andrew Cuomo (D) should take similar action to Massachusetts and mandate testing at long-term care facilities, such as residential, veteran and nursing homes, for all staff and residents. 

The petition, change.org/p/andrew-m-cuomo-save-my-son-s-life-new-york-group-homes-need-mandatory-covid-19-testing, has already raised over 1,000 signatures since it started Friday, May 1.

The site is operated through the New York State Office for People with Developmental Disabilities, which sets the rules and regulations for facilities such as UCPLI. 

Camille Schramm, the director of development and public relations for UCPLI, said her company, which was mandated to close every service except for the residential homes since March 17, has struggled to get their hands on the necessary PPE. Through donations and requisitions they’ve managed to procure enough masks and gloves for now, but they have struggled to receive the necessary number of gowns.

Otherwise, facilities like hers “should be in the top 10” of long-term care organizations that need targeted testing. Residents cannot simply go to the local pharmacy to get tested, a plan the governor said is currently in the works. Many have major communication problems and mobility issues. Many are confined to wheelchairs.

UCP would not release the number of people at their 31 facilities who have tested positive for the virus, citing resident and family confidentiality, though she said they have fared better than others in the field.

“We’ve been hit, but not as hard as some of the other agencies on the Island due to the safety protocols and precautions we have in place,” Schramm said. 

Currently, the policy for staff who present symptoms isthat they are sent home for at least two weeks and they require a doctor’s note to be allowed back in. After learning of a positive case, UCPLI brought in a company to clean and sanitize the facility, which Schramm said is “costly, especially considering the number of homes we have.” 

For residents that start to show symptoms, they are self-isolated in their rooms. Though if they start to display problems with breathing, they are sent to hospitals where many remain because many also have compromised immunities. 

“They are part of an underserved demographic population that are very challenged by something like this,” Schramm said.

At the end of March, Massachusetts deployed National Guard technicians to long-term care facilities to attempt to test all workers and residents across the state, though things have only ramped up since then. After an April 27 $130,000 state funding plan, the National Guard has completed more than 28,000 tests at 525 care facilities in Massachusetts, according to The Boston Globe. Though the Bay State is ranked 10th in overall nursing home population, currently New York is ranked at the top with over 101,000 patients.

The OPWDD issued a statement saying testing is being prioritized for people receiving supports from OPWDD or service providers who display symptoms, adding that the state “continues to expand testing opportunities as new tests and locations become available.”

“OPWDD is taking the threat of COVID-19 to the people we support and the broader community very seriously and has activated our emergency response team to closely monitor all reports of possible contact within our system across the state,” the statement read. “All staff are fully trained on infection control practices and OPWDD has released guidance to staff and voluntary provider agencies regarding visitation, PPE use and quarantine protocols at our facilities. OPWDD monitors levels of PPE in all of our community residences, both state and provider operated, and has created a 24-hour emergency services number for providers and staff to contact when issues arise.” 

Residential facilities, mostly nursing homes of adult care facilities, have come under severe scrutiny since it was revealed a huge portion of COVID-19-related deaths have come from these places that house some of the most at-risk populations. As of May 5, New York State reported nearly 20 percent, or 4,813 deaths, in New York have come from these locations. Suffolk County has suffered 593, but many suspect COVID-19 deaths have gone unreported at these locations, and deaths may be even higher.

Hoey said targeted testing is the best way to stymie the growing number of deaths at these facilities.

“That will knock down the death rates,” he said. “The only reason [Cuomo is] not doing it because there’s no pressure for him to do this. “

Bud Conway and Kalpana Astras outside the camper where Nic Astras is staying during the ongoing pandemic. Photo by Kyle Barr

At the end of a grueling 12 hour shift as an internal medicine resident at Long Island Community Hospital in East Patchogue, Setauket resident Nicolas Astras can’t simply enter his home, put his feet up on the couch and relax, not anymore, not since the pandemic hit Long Island hospitals like a tidal wave. 

Drawings Kalpana’s daughter drew for her father. Photo by Kyle Barr

He has a wife and three kids, ages 13, 10 and 5. For all he knows, he is covered in COVID-19. If he wanted to go in and take off his clothes and shower, he knows he could potentially spread the virus to other parts of the house and to his family members.

Astras’ wife, Kalpana, said her husband had few choices. He could have lived in an unused hotel room or house, but that would have been a bitter and depressing pill to swallow, having nobody to come home to, nobody to talk to. 

Then, Kalpana said after friends referred her to Facebook group RVs 4 MDs, the family was given a third option, one that while nowhere near as good as getting to be home with the family, it would offer a degree of separation and homeyness, despite the need to be separated.

“It has given us an area where he can be secluded from us so he cannot give us anything,” Kalpana said. “It makes him feel safe that he’s not spreading it.”

From the street, it seems like the Grey Wolf camper parked in Nicolas and Kalpana Astras’ Setauket driveway would just be a summer getaway vehicle. Though now it has become a saving grace. It belongs to Bud Conway, a Farmingville resident who heard about the Facebook group through a family member. Not having an account, he signed up and put his name down as having a camper. Soon, he was linked with the Astras family, and that was that.

Kalpana, who herself is still working full time at a clinical trials company, takes in her husband’s clothes to be washed, trying to be careful around them. She also stocks up the fridge and makes meals for the doctor when he goes to work. Every time she enters the camper, she wears an N95 mask and is careful when touching anything.

Though it’s not completely isolated. The daughter’s bedroom overlooks the driveway on the second floor, and when the husband walks out to get air in the morning, the daughter talks with him and connects.

Despite how thankful the family is, Conway said it wasn’t much, even with him and an electrician friend traveling there to help fix the camper when something was broken. With him not using it, he said it was the least he could do.

“I’m not the hero here,” he said. “It’s just a camper, not a kidney.”

RVs 4 MDs started March 24 as just Texan Emily Phillips, the wife of an emergency room physician, was convinced to ask the community if anyone had an RV for her husband. Days later she founded the Facebook group,which has since blown out into a nation-spanning movement to connect camper and trailer owners to doctors who need to be able to self-quarantine.

But over a month since that started, as the number of hospitalized patients decline in the county, officials say there is some hope on the horizon. But for hospital workers still in the midst of it, the silver linings usually come not from thinking of work, but with communicating with the family.

“Yesterday he said they extubated some patients, which is good news — it’s a flicker of good news,” Kalpana said. “It’s really to boost his morale, to keep him home with us.”

Inside the camper, a number of index cards lay on the table in the suffused light. They show pictures of rainbows, hearts and messages saying, “We love You” and “Your Our Hero,” all from his kids.

“My 10-year-old, her way of coping is with art,” Kalpana said. “Every time I come in with food, she does artwork, and he just collects them on the table.”

Stock photo

Despite the worrisome sign that net hospitalizations rose for a second straight day in Suffolk County, the area has still met one of the qualifications for a phased reopening.

The U.S. Centers for Disease Control and Prevention has recommended that hospitals in an area have a three-day moving average where the number of hospitalizations from COVID-19 declines.

Over the last day, the number of hospitalizations from the coronavirus rose by 18, after inching up by four on Monday, bringing the total to 835 people. The number of people hospitalized with COVID-19 on Sunday had declined by 38, which means the three day moving average was a decline of over five people.

“The fact that we’ve had two days in a row of increasing hospitalizations is definitely something I’m concerned about,” County Executive Steve Bellone (D) said on his daily conference call with reporters. He doesn’t “want to see that trend continuing.”

For the second consecutive day as well, the number of people who were discharged from the hospital increased at a slower pace than it had in the last few weeks, with 37 people heading home to continue their recovery.

“Is this an indication that the people that are in the hospitals, which would be common sense, are people who are more sick?” Bellone said. He suggested that would be “logical,” although he doesn’t have any specific indication behind the numbers about why the net hospitalizations have climbed amid conspicuously lower discharges.

While Gov. Andrew Cuomo (D) has discussed a phased reopening of the state on May 15, when New York Pause ends, the decision of when to open different regions will depend on the data from those area. Upstate, for example, hasn’t been hit as hard as downstate areas like Nassau and Suffolk County.

“We are doing the work to prepare for that reopening downstate,” Bellone said. While the county executive is hopeful Suffolk County could open as soon as possible, he said the county would have to hit a range of metrics to make that possible.

These measures include a 70 percent or lower use of hospital beds, which is about where the county stands now. That, however, does not include elective surgeries, which, once they start picking up again, will require some hospital bed usage.

Additionally, the number of new hospitalizations in Suffolk County will need to be 30 or lower based on a three-day rolling average. Over the last 24 hours, the number of new hospitalizations from COVID-19 was 50.

“We’re not there yet,” Bellone said.

Amid ongoing testing throughout the county, including in seven hotspot testing sites, the number of new positive tests climbed to 715 to 38,252. The percentage of positive tests is 34.6 percent.

On the positive side, the number of people in the Intensive Care Unit declined by seven, as the number of intubations also fell.

“That’s a very good sign,” Bellone said.

The number of people who have died from complications related to coronavirus climbed by 23, bringing the total to 1,296.

“We know the terrible grief and tragedies that this virus has wrought upon our community,” Bellone said, as residents “haven’t been able to grieve in the way we are accustomed to as a community.”

The American Red Cross is providing crisis counselors who can work with families, supplying emotional and spiritual support.

Residents who would like to receive confidential help can log in to www.redcross.org/nyscovidfamilysupport where they will fill out a nine-question form. Alternatively, residents can call 585-957-8187.

Bellone said New York State and Northwell Health tested 700 police officers yesterday at the Suffolk County Police Academy for the presence of antibodies to the virus.

Suffolk County Police Commissioner Geraldine Hart said the police would use the information to track the location of positive cases to see if there are hotspots within the department.

Finally, Bellone is launching a new space on the county site where residents can share positive stories, at www.suffolkcountyny.gov/dashboardofhope. He is encouraging people to share positive stories about teachers this week, during National Teacher’s Week. Residents can share good news or can link to facebook, twitter, or videos.

Lindsey David, a Medford EMT, is tested for coronavirus antibodies at New York Cancer and Blood Specialists in Port Jefferson Station. Photo by Kyle Barr

With the amount of testing for COVID-19 still nowhere where it needs to be, locals in emergency service are starting to get such necessary information whether they have COVID-19 or its antibodies from some unexpected places.

Kenneth Spiegel, a Medford volunteer department member, is tested for COVID-19 antibodies. Photo by Kyle Barr

The New York Cancer and Blood Specialists location in Port Jefferson Station started offering tests to firefighters, emergency responders and other essential workers Saturday, May 2. Throughout the morning, cars from districts such as Medford pulled into the parking lot located at 1500 Route 112 in Port Jefferson Station. Many who arrived said this had been their first opportunity to get tested, even though as EMS workers in an ambulance they have been handling COVID-positive patients for nearly the past two months.

Marcia Spiegel, an EMT for the Medford Fire Department, said she had been exposed all the way back in early March when at a surprise party she learned one of the persons there had it, but even close to two months since,she was never able to get tested.

Both her and her husband Kenneth both traveled to Port Jefferson Station to get tested, as did many from her department that morning May 2.

“If we’re in fact negative, it doesn’t mean that we still can’t get sick, but if we know if we have the antibodies, that would be better,” she said.

Staff in full body gear went out to each car to administer the tests, including the notorious long-stemmed nasal swab to test for the virus and drawing blood to test for antibodies. About 35 visitors came to the location last Saturday, including some essential workers from a construction company. NYCBS officials said another 50 would attend next Saturday’s marathon. The testing is held Saturdays at that specific location when no other employees or clients come through, medical workers said.

Lindsey David, a Medford EMT, said she donated blood right at the start of the pandemic, but has been looking for ways to help even more. That would be especially important if she can confirm she may have had the virus and perhaps can donate her blood plasma if she indeed has the antibodies.

“I just want to help any way I can,” she said.

Diana Youngs, a VP of Clinical Operations at NYCBS, said all readings from the tests are being done in-house at the Route 112 location. Fire departments and companies receive their antibody tests within the day, while the virus test is available within the next 48 hours.

Lindsey David, a Medford EMT, is tested for COVID-19 at New York Cancer and Blood Specialists in Port Jefferson Station. Photo by Kyle Barr

Researchers are still trying to understand what are the likelihood of developing antibodies for the virus after infection, but theoretically, Youngs said, if one has tested negative for the virus and for antibodies then likely they have never had the virus.

“They don’t know, and say you call an ambulance to your house, you don’t know if they have it,” Youngs said. “So it works both ways, it helps everybody.”

All testing supplies are coming from the company’s own suppliers.

Such efforts are some of the few non-governmental testing initiatives on the island that specifically offer help to emergency responders. While Gov. Andrew Cuomo (D) announced plans for testing to be held at local pharmacies, specific details of locations and how those tests will be processed have not yet seen the light. New York state is also offering people the chance to try and get tested, with people able to visit covid19screening.health.ny.gov

Though, barring a vaccine, officials said testing is the only way the economy will eventually be able to safely reopen.

“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.”

Stock photo

The closely-watched hospitalization rate crept up in the last day, disrupting a streak that had Suffolk County within a day of reaching the critical 14-day declines the Centers for Disease Control and Prevention had recommended for a phased reopening.

The number of people hospitalized with COVID-19 rose by 4 to 817, as the number of people discharged from the hospital increased by 33, which is about a third of the pace for the last few weeks.

The slight increase in hospitalizations, however, does not reset the CDC guidance clock, as Gov. Andrew Cuomo (D) said the state would use a rolling three-day average of hospitalizations.

“We are confident we will meet that metric,” County Executive Steve Bellone (D) said on his daily conference call with reporters. “Based on what we’ve seen over the last couple of weeks, my expectation is that will be declining once again tomorrow.”

Cuomo’s daily press briefing outlined the basics for reopening the New York, though downstate counties such as Nassau and Suffolk are going to have to wait longer than upstate, which could see things open much sooner as the May 15 deadline for New York Pause order expires.

The number of people in Intensive Care Unit beds declined by seven to 317.

The number of people who have tested positive for the coronavirus climbed by 563 to 37,537. Bellone said hotspot testing sites that have also provided food distribution would now include Huntington Station. Last week, the county added food distribution at Wyandanch and Brentwood.

The number of people who have died from complications related to COVID-19 increased by 17 to 1,273, which is lower than recent fatality rates. It still, however, represents the loss of another 17 people.

Separately, Northwell Health and New York State have started the process of antibody testing at the Suffolk County Police Academy for law enforcement today. The health care professionals tested 400 police officers today.

“We will be testing not only police officers, but also correction officers, deputy sheriffs and probation officers,” Bellone said. The testing will expand to include first responders, Emergency Services Staff, fire and essential employees.

Bellone urged anyone interested in joining the county’s Suffolk Forward business initiative, which is a joint effort with Stony Brook University, to reach out through 311.

A blood sample with respiratory coronavirus positive. Stock photo

Even as Suffolk County moves closer every day to the possibility of restarting the economy and reopening shuttered businesses amid a steady decline in hospitalizations from COVID-19, the number of positive tests for the county as a hole and for hotspot testing sites for the virus continue to increase.

In the last 24 hours, 889 people tested positive for the coronavirus, bringing the total who have tested positive for the virus that has caused the pandemic to reach 36,974, bringing the total above the number of confirmed cases for Switzerland and about 44 percent of the number of confirmed cases out of China, according to data from Johns Hopkins University.

The number of positive tests “should be a little bit of a wake up call for people,” County Executive Steve Bellone (D) said on a conference call with reporters. “We know the margin for error in the rate of transmission is not great.”

Indeed, the county executive said the transmission rate for each positive test is about 0.75. If the county rises to 1.1 on the rate of transmission – meaning each infected person passes along the virus to more than one other person – the virus could “spread out of control,” Bellone said. “We don’t have a lot of room to spare in these numbers.”

Bellone urged Suffolk County residents to understand that reopening “has to be done right.”

Gov. Andrew Cuomo (D) said during his daily press briefing today that he will work to figure out what is causing the new infections, which would enable a more targeted approach to protecting the population, Bellone suggested.

As New York starts the seventh week of the governor’s New York Pause tonight, the number of people who have died in Suffolk County continues to climb. Over the last day, 29 people have died from complications related to Covid-19, bringing the total number of fatalities in the county to 1,256.

“There is not a person in Suffolk County who hasn’t been either directly impacted or knows somebody who has been affected,” Bellone said.

On the positive front, the number of hospitalizations continues its steady decline, with a reduction of 38 residents in the last day, bringing the total to 813. That is a decline of close to 51 percent from the highest coronavirus hospitalizations, which the county reached April 10. If the numbers decline over the next two days, Suffolk County will have reached 14 consecutive days where the net number of hospitalizations from the virus came down. That would meet the guidelines from the U.S. Centers for Disease Control and Prevention to start a phased reopening of the economy.

The number of people in Intensive Care Units also declined by three, to 324.

As of today, the number of people in hospital beds and in the intensive care units hovered around 70 percent, which is also a targeted figure from the CDC for reopening, as the health agency would like hospitals to have enough room for any future increase in admissions if the infection rate increases in the fall or winter.

In hotspot testing sites, the number of positive tests was 1,038 out of close to 2,400 results, which brings the positive rate of testing to 43.2 percent. That is still above the rate of 35.3 percent for the rest of the county, but it is a narrowing of the gap, Bellone said.

Bellone’s office distributed 24,000 personal protective equipment yesterday, bringing the total to 3.2 million since the crisis began. Yesterday, the county received 6,250 Tyvec Coveralls from the Federal Emergency Management Association.

As the warmer weather reaches Long Island, the Suffolk County Police Department continues to monitor the activity of people who have been cooped up indoors for weeks, cooking meals, cleaning their homes, and taking care of their children and, to the extent they can, continuing to manage their jobs.

Suffolk County Police Commissioner Geraldine Hart said the volume is up in the parks and outside in general. “Overwhelmingly, people are in compliance” with social distancing guidelines, Hart said. “We’re hoping that’s what we’re going to see moving forward.”

Hart said the police will also continue to monitor any demonstrations in reaction to New York Pause, which is scheduled to end on May 15. She said if the police saw opportunities to provide face coverings to protestors or to remind them to maintain social distancing, the officers would do that.

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.”