Health

To reduce binge eating, take the dog for a walk while social distancing. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Obesity is an ongoing struggle for many in the United States. The latest statistics suggest that 40 percent of the population is obese. Obesity is a disease unto itself and is defined by a BMI (body mass index) of >30 kg/m2, but obesity can also be defined by excess body fat, which is more important than BMI.

Obesity has been associated with COVID-19, especially in the U.S. In a study involving 5700 hospitalized COVID-19 patients in the NYC area, the most common comorbidities were obesity, high blood pressure and diabetes (1). Of those who were hospitalized, 41.7 percent were obese.

In a study in China, results showed that those who were overweight were 86 percent more likely to have severe COVID-19 pneumonia, and that percentage increased to 142 percent when obesity is reached (2). The study has yet to be peer-reviewed, but it complements other studies.

Another study from France indicates that those with a BMI >35 (severely obese), were more likely to be put on ventilators (3).

In fact, one study’s authors suggested quarantining should be longer in obese patients because of the potential for prolonged viral shedding compared to those in the normal range for weight (4). And though age is a risk factor for COVID-19, among those younger than 60 and obese, there is a two-times increased risk of being admitted to the hospital, according to a 3,615-patient study at NYU Langone Health (5).

Why are you at higher risk for severe COVID-19 with obesity? 

According to the prevailing theory, obesity may interfere with mechanical aspects of breathing, thus increasing airway resistance and make gas in exchange more difficult in the lung. It may also impede on lung volume by exerting pressure on the lungs and may involve weaker muscles necessary for respiration (6).

Why is excess fat more important than BMI? 

First, some who have elevated BMI may not have a significant amount of fat; they may actually have more innate muscle. More than 25 percent of my patient population is “solidly built,” which means they have greater muscle mass as well as too much excess fat. (I have a body analysis scale that detects muscle mass and fat through two different currents of ohms.) Visceral fat is the most important, since it’s the fat that lines the organs, including the lungs.

For another, fat cells have adipokines, specific cell communicators found in fat cells that communicate with other fat cells but also other systems such as the brain, immune system, muscles, and liver. Adipokines can be mediators of both inflammation and insulin resistance, according to an en-docrinology study (7). In a study of over 4,000 patients with COVID-19, the author suggests that inflammation among obese patients may be an exacerbating factor for hospitalizations and severe illness (8). 

If we defined obesity as being outside the normal fat range – normal ranges are roughly 11-22 per-cent for men and 22-34 percent for women – then close to 70 percent of Americans are “obese.”

Inflammation reduction and weight-loss combined

In a randomized controlled trial with 75 participants comparing a plant-based diet to a control diet, there was a greater than 14 lbs. weight reduction and roughly 10 lbs. fat reduction over a 14-week period (9). Of the weight lost, about 70 percent was excess fat. Remember, excess body fat, through adipokines, may be inflammatory and increase the risk of severe COVID-19. 

The weight reduction with a plant-based approach may involve the increase in fiber, reduction in dietary fat and increased burning of calories after the meal, according to Physician’s Committee for Responsible Medicine (PCRM) (10).

You also want a diet that has been shown to reduce inflammation.

We are currently submitting a small study for publication involving 16 patients from my clinical practice. It shows that those who ate a whole food plant-based LIFE (low inflammatory foods every-day) diet over a seven-day period had a significant decrease in inflammation measured by hsCRP (high sensitivity c-reactive protein). This occurred in those who completely changed their diets to the LIFE diet, but also occurred in those who simply added a greens and fruit-based smoothie daily to their existing diet.

In my practice, I have seen a number of patients lose a substantial amount of weight, but also excess body fat, over a short period. For instance, a 70-year-old male lost 19 lbs. of weight and 12 lbs. of excess body fat over a six-week period. His inflammation, which was very high to start, dropped substantially to the border of optimal levels, using hsCRP as the inflammation measurement. This patient and many others have seen tandem reductions in both weight and inflammation. To boot, this was a cardiac patient whose cardiologist had considered a stent, but later said he did not need it after reducing his inflammation.

Exercise to reduce binge eating

While sheltering in place with fewer physical activities available, it is very tempting to binge eat or use food as a leisure activity. But there is a way around this. 

In patients who are overweight and obese, those who exercised compared to those who were sedentary, showed a significant reduction in binge eating over a 12-week intervention (11). The participants at baseline had a mean BMI of 30.6 kg/m2 and a mean age of 43 years. Of the 46 participants, almost two-thirds were women. Exercise can be as easy as walking or running outside while social distancing; doing exercises with your own body weight, such as calisthenics; taking online exercise classes (of which there are plenty); or using exercise equipment you have at home, might help allay binge eating.

If COVID-19 does not convince you that losing excess body fat is important, then consider that obesity contributes to, or is associated with, many other chronic diseases like cardiovascular disease, high blood pressure, and high cholesterol, which also contribute to severe COVID-19. Thus, there is an imperative to lose excess body fat. Now, while we’re sheltering in place, is the time to work on it.

References:

(1) JAMA. online April 22, 2020. (2) https://doi.org/10.2139/ssrn.3556658 (2020). (3) Obesity. online April 9, 2020. (4) Acta Diabetol. 2020 Apr 5: 1–6. (5) Clin Infect Dis. Online April 9, 2020. (6) Chron. Respir. Dis. 5, 233–242 (2008). (7) Front Endocrinol (Lausanne). 2013; 4:71. (8) MedRxiv.com. (9) Nutr Diabetes. 2018; 8: 58. (10) Inter Journal of Disease Reversal and Prevention 2019;1:1. (11) Med Sci Sports Exerc. 2020;52(4):900-908.

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. 

From left: Nassau County Executive Laura Curran (D), Suffolk County Executive Steve Bellone (D) and former Congressman Steve Israel. Photo from Bellone’s office

For the first time, Suffolk County has fallen below the three-day rolling average for new hospitalizations mandated for economic reopening yesterday, starting a clock that, if the pattern holds, could allow the county reach another metric by May 25.

The three-day average for new hospitalizations for Suffolk County, which is based on the total population, is 30.

“It’s a good thing to say we have met that decline in new hospitalizations for a three-day rolling average,” County Executive Steve Bellone (D) said on his daily call with reporters.

At the same time, the number of people in the Intensive Care Unit dropped by two, to 214, which is “another piece of good news,” Bellone said.

Still, the overall numbers aren’t all positive.

The number of people hospitalized with COVID-19 increased by 10 for the 24-hour period ending yesterday, bringing the total hospitalizations to 585.

Additionally, the number of new positive tests over the last day rose by 243, bringing the total, excluding antibody testing, to 37,305.

Hospital capacity remains close to the 70 percent level mandated for economic reopening. The number of available beds is 894 out of a total of 2,965 beds. The number of ICU beds, meanwhile, was 199 out of a total of 602, which exceeds the 30 percent availability necessary.

Four upstate regions have been cleared to begin the reopening process starting May 15, after Gov. Andrew Cuomo’s New York Pause order is set to end. At the same time, all of Long Island, including both Nassau and Suffolk counties, will be considered one for understanding when it will reopen.

At the same time, the county is aiming to have additional bed capacity, as hospitals hope to start offering elective surgeries again for residents who have put off procedures for weeks or even months.

The number of people who died in the last day was 26, bringing the total to 1,680.

“We are with you as you grieve this terrible loss,” Bellone said.

Amid hotspot testing, 1,595 people have tested positive for COVID-19 out of 4,386 results, bringing the infection rate to 36.4 percent of the total tests.

Bellone’s office distributed another 220,000 pieces of personal protective equipment yesterday, mostly to nursing home and adult care facilities.

Separately, Bellone invited veterans to a town hall scheduled for this evening at 5:30 p.m. Those interested in attending virtually can access the town hall at facebook.com/SteveBellone.

Finally, on Friday, the 106th Rescue Wing of the Air National Guard will salute health care workers with a flyover that starts in Riverhead at 12:15 pm, travels over several hospitals, and ends at 1 p.m. at Jones Beach.

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

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

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

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

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

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

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

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

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

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

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

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

“The majority will do well,” Beneri said.

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

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

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

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

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

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

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

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

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

Gov. Andrew Cuomo. Photo by Sara-Megan Walsh

While public health officials initially expressed concerns for the elderly and those with underlying medical conditions amid the COVID-19 pandemic, Suffolk County has started to see an increasing number of cases of what’s known as Kawasaki disease.

In the county, seven children are currently hospitalized with a disease that doctors believe is linked to COVID-19. One child has died from this disease, which causes inflammation that can require medical attention. Children in Europe and the U.S. including in San Francisco, have exhibited symptoms of this disease.

Gov. Andrew Cuomo (D) said today the condition has impacted 100 people and has killed three. Kawasaki disease, also known as pediatric multi-system inflammatory syndrome, affects children mostly between ages 5 to 14, though it has affected some children younger than that.

The pandemic “does impact kids directly,” Suffolk County Executive Steve Bellone (D) said on his daily conference call with reporters. Although the county, like New York City which has several cases and deaths as well, “doesn’t completely understand it at this point.” Bellone urged children to wear face masks and practice social distancing in the same way as their parents and grandparents.

“We’ve known from the beginning that kids transmit the virus,” Bellone said. “This is all about protecting everyone as we try to restart our economy.”

In the last day, the number of new positive tests for COVID-19 increased by 150 to 37,062. Those numbers are about 10 percent of the new daily total just a few weeks ago.

Through yesterday, the number of residents hospitalized decreased by 15 to 575, which is “another real indication of the progress we are making.”

The number of people in Intensive Care Units fell by six to 216.

Of the 2,973 hospital beds in the county, 918 are available, while 209 ICU beds are available among the 619 in the county.

Amid a death toll that has risen by another 15 in the last day, bringing the total on Long Island to 1,654, the Association of Mental Health and Wellness is offering bereavement support groups online, starting next Tuesday.

“For those who have lost loved ones, friends, family members, this is there for you,” Bellone said. There are different categories of support groups for grieving adults, peer bereavement, veterans groups and a creative arts bereavement group.

Those interested in these support groups can sign up or register through bereavement.mhaw.org.

At locations in Shirley and Selden, Rite Aid will provide free COVID-19 testing to anyone who is over 18. Interested residents need to pre-register and have identification through the web site riteaid.com.

Stock photo

A month ago yesterday, the number of people hospitalized in Suffolk County with COVID-19 was at a staggering 1,658, prompting the rapid-fire build up of a hospital extension at Stony Brook.

Yesterday, after further declines in hospitalizations throughout the county, the number of people hospitalized with a virus that has disrupted life across the county and the planet, was 590, which represents a 64 percent decline from the peak a month earlier.

Over the weekend, the total number of residents hospitalized fell by 113, while the number of people in the Intensive Care Units declined by 36, bringing the total number in the ICU to 222.

The number of people discharged from the hospital continued to fall, with 70 leaving discharged on Saturday and 83 leaving the hospitals on Sunday.

Capacity for hospital beds and ICU beds both were around the targeted 70 percent, which means that Suffolk County has met four out of the seven criteria for a phased economic reopening. This is better than a week ago, when the county only met two.

The three criteria the county still hasn’t met include hiring an additional 400 to 450 contact tracers, a reduction in hospital deaths and a reduction to 30 or below in the number of new hospitalizations.

County Executive Steve Bellone (D) said on his daily conference call with reporters that the last of those, the number of new hospitalizations, is the one he’s most concerned about meeting to reopen the economy.

Over the last 24 hours, the number of people who have tested positive for the virus, excluding the antibody testing, was 209, bringing the number who have tested positive through non-antibody screening to 36,911.

Excluding the antibody test, which screens for the presence of immune cells residents presumably formed to fight off a virus they may not know they had, positive tests in the last day represent just over 10 percent of the total testing.

“That is significantly lower than we’ve seen in the past,” Bellone said.

Gov. Andrew Cuomo said today several upstate regions will be able to begin opening their economies after May 15, when the New York Pause executive order is set to end. Each county is in charge of establishing its own phases for reopening when the time comes.

The virus continues to take the lives of Suffolk County residents, with an additional 22 people losing their battle over the last day, bringing the total to 1,639.

A new dashboard is available to check what criteria Suffolk has made toward its reopening initiatives.

On Wednesday, Bellone will conduct a second Facebook live town hall for veterans. This time, he join Suffolk County Legislator Susan Berland (D-Dix Hills) and former National Football League player and current Jets analyst Marty Lyons.

Through the Marty Lyons Foundation, the group has delivered over 7,900 wishes to sick children since its founding.

Jennifer Hoang and James Labriola at the Acupuncture Tradition in Port Jeff. Photo by Kyle Barr

In the lot of a small medical park in Port Jefferson, people relax in the drivers’ seats of their cars, the subtle smell of lavender wafting from barely cracked windows. In amidst the panic, both of the overriding senselessness of the world being turned upside down, and the smaller, creeping tide of waiting for things to get better, it was as close to an oasis as the current times could see.

Mather OR nurse Olga Turner receives acupuncture by Jennifer Hoang. Photo by Kyle Barr

Done up in mask, gloves, hair cap, goggles and lab coat, acupuncturist Jennifer Hoang, the owner of Acupuncture Tradition in Port Jeff, has been providing small free-of-charge acupuncture sessions to people in the community. It does not matter if they were previous clients of her’s. All are welcome as long as she has supplies.

To her, it’s her way of giving back. As so many people are stuck at home, and many with chronic conditions unwilling to visit the hospitals and possibly contract the virus, the acupuncturist is offering whatever she can to aid people, especially those with anxiety, depression, and may help those in pain who may not have access to prescribed painkillers during the crisis.

“So many doctors are overloaded in their work and have not been able to take care of the patients who are not COVID,” she said. “There’s this whole population who are not being taken care of.”

The nature of the current pandemic makes it especially hard for practices like Hoang’s. Normally a procedure on different parts of the body could take upwards of an hour, but close proximity is not in the cards with the current crisis. Still, doing what she can, she is offering procedures on people’s ears while they remain in the car, and she remains outside.

Olga Turner, an operating room nurse at Mather Hospital, has been a patient of Hoang for a little over a year. She suffers from vertigo, anxiety, depression and upset stomach, but the acupuncture treatments, she said, has helped her immensely. She said being able to return to get any sort of treatment for her ailments, while she returns to work in the hospital, means so much to her.

“We are so used to caring for everybody else, and that’s one of my biggest issues because I have asthma so I couldn’t go into the city,” Turner said. “It just gets me that I can’t help more than I want to.”

Hoang knows of the crisis situations, and the impact such small services can have on the people experiencing it. She knows it from her childhood and from her father, Ngoc Hoang. When she was around 7 years old, her father and their whole family were caught up in the wave of “boat people” fleeing Vietnam after the Vietnam War in the late 1970s. Her father, was a Chinese medicine practitioner provided acupuncture treatments to the refugees right on the ground in the harsh jungle of South Vietnam and Malaysia. She and her brothers and sisters watched their father help others when so few people could.

“There were people who were really sick, and there was no medicine — there were doctors there but without medicine, there was little they could do,” Hoang said. “[My father] was able to help so many people … I would see grown men crying in pain or suffering from something else, and after an hour they walked out, better. That was something so powerful to me. I knew from then I was going to be an acupuncturist.”

The small Port Jeff team seems to have the process down. After filling out paperwork, Hoang performs the procedure, putting the needles in five points in the ear. The person then relaxes for a time after, normally around 30 minutes. On their cars is placed a small sign calling the car a “waiting” or “treatment room,” depending on what step a person is at. Each person is given a cotton ball scented with lavender, plus a small bag containing tea supplies.

Mount Sinai resident James Labriola has started to volunteer and help Hoang during these sessions. First reading about it, he simply called up Hoang and said, “You helped me, can I help you?”

Labriola said his dad had been to several sessions with Hoang before the start of the pandemic. His father, suffering from Parkinson’s disease, would limp into the acupuncture’s office, but the man would leave with a steady gait after treatment. After a few days, the pain would come back, but Labriola said seeing him move freely, even for such a short time, was worth it.

“It would usually last only two days, but it gave him two days of freedom, and that was amazing,” he said.

The acupuncturist has seen an average of 10 cars each day they’ve done the free procedures. Saturday, May 9, she treated a total of 17. Each is done for free, though she has accepted donations to help her afford the materials, especially needles. As long as she has the time and resources, she said she will continue to offer the service as long as the crisis mandates it.

“People are losing their income or falling back into their addictions,” Hoang said. “It’s wonderful to stay connected to the community, to my current patients, and offer some kind of relief.

Acupuncture Tradition, located at 640 Belle Terre Rd. Building D, is hosting other sessions Tuesday, May 12 from 3 to 6 p.m. and Saturday, May 16 from 1 to 4 p.m.

This article was amended May 14 to correct the experience of Hoang’s father, as well as small details of the services provided.

People in Port Jefferson line up to eat at Prohibition Kitchen, doing their best to stay six feet apart. Photo by Kyle Barr

An additional 669 people tested positive for COVID-19 through 10 p.m. last night, bringing the total to 42,022.

Of the positive tests, 446 came from antibody tests, which typically test for the presence of antibodies that indicate that a person had the infection and has developed an immune response to it.

Among the examinations at hotspot testing sites, 1,473 positive tests have come back from a total of 3,952 results. Positive tests at the hotspots represent 37 percent of the total, compared with 32 percent for the county as a whole.

Suffolk County Executive Steve Bellone (D) didn’t have an update on the number of hospitalizations, which are a closely watched metric that can help determine when the county can begin to reopen the economy.

Meanwhile, an additional 20 people died over the last day, bringing the total of fatalities that include a COVID-19 positive diagnosis to 1,617.

Meeting the U.S. Centers for Disease Control’s and New York States criteria to begin the reopening process is still a certain way’s off. Suffolk has to maintain current declines in hospitalizations, as well as double the number of contract tracers it had as of May 8, 230 to around 400 to 450.

With Northwell Health, New York State has been testing Suffolk County police officers for the presence of antibodies. Of the 1,115 results, 65 tested positive, which means that 6 percent of the officers have had the virus.

“That’s an extraordinary number,” Bellone said on his daily conference call with reporters, noting that it was below the 11.4 percent for Long Island overall and 12.3 percent for the state as a whole.

The low rate of infection reflects measures the department has taken “right from the start” to contain the infection among law enforcement, Bellone said.

Over the last 10 days, the number of sworn officers from the Suffolk County Police Department who have tested positive for the virus hasn’t increased at all, with 87 officers testing positive.

Foods that comfort the mind and body protect you from chronic diseases in the long term. Stock photo
Focusing on real ‘comfort food’ will improve your outcomes

By David Dunaief, M.D.

Dr. David Dunaief

I think it’s fair to say that our world has been radically altered by the current COVID-19 pandemic. If you are at home weathering this storm, it can feel like you are in a literal silo. 

So naturally, we need to find things that make us feel “better.” Many of us reach for food to help comfort us. Guess which food item has had the largest sales increase in the U.S. from 2019. Here is a hint: it’s not broccoli. It’s frozen cookie dough, where sales are up 454 percent (1). 

But there is a difference between food that comforts just the mind and food that comforts both the mind and the body. What is the difference? Let’s look at two recent examples from my clinical practice. 

Food that comforts the mind and body 

Stock photo

First, let’s look at the results of a 71-year-old male who stopped eating out during COVID-19, like so many of us. Apparently, for this patient, eating out meant indiscretions with his diet. While at home, there was less temptation to stray from his dietary intentions. The results speak for themselves. 

In a month, his nutrient level improved, measured using serum beta carotene levels. His inflammation, measured by c-reactive protein (CRP), was reduced 40 percent. What is the importance of inflammation? It is the potential basis for many of the chronic diseases that are rampant in the U.S. (2). His kidney function increased by about 14 percent with an increase in his glomerular filtration rate (GFR), which helps remove waste from the kidney, from 51 to 58. This patient, who suffers from gout, also found his uric acid dropped. Finally, and most importantly, his symptoms improved, and he garnered more energy. He described himself as enjoying food more.

I am not suggesting you don’t order out, but do it wisely. Diametrically opposed is our second example. 

Food that comforts the mind only

Stock photo

This 72-year-old female decided to embrace ultra-processed foods, adding cookies, cakes and sour-dough breads to her diet. Her kidney function decreased by more than 15 percent, with the GFR shifting from 88 to 63. Her inflammation, measured by CRP, went up by 75 percent. Her LDL, “bad cholesterol,” increased by more than 20 percent. Her allergy symptoms worsened. She described herself as more sluggish and, to boot, she gained five pounds.

What makes these examples even more interesting is that both patients are deemed in the high-risk category for getting severe COVID-19 and being hospitalized. COVID-19 is associated with elevated CRP, which may increase the risk for more lung lesions and the risk of severe disease (3).

What is the moral of the story? Use this time to focus on foods that comfort both the mind and the body. Make food work for you and against the common enemies of COVID-19 and chronic diseases that are putting people at higher risk for viruses.

What about exercise? 

Just because we are cooped up indoors most of the time does not mean we can’t exercise. Time and again, exercise benefits have been shown. Yet, we are sitting more and, with social distancing, we have less incentive to go outside or opportunities to socialize, go to the gym or do many of our usual activities.

However, not to fret. There was a recent small study with eight volunteers equally split between men and women. Results showed that four-minute intervals of exercise throughout the day that interrupted continuous sitting led to a substantial improvement in triglycerides and metabolized more fat after high-fat meals the next day, compared to continuous sitting for eight hours uninterrupted and then eating a high fat meal the next day (4).  

The participants used a stationary bike, exercising intensely for four seconds and then resting for 45 seconds, repeating the sequence five times in a row. They completed this four-minute sequence once an hour for eight hours. Their daily intense exercise totaled 160 seconds. This bodes well for very short bursts of exercise rather than sitting for long periods without movement.

Not everyone has a stationary bike, but you can do jumping jacks, run in place, or even dance vigorously to your favorite tunes once an hour.

Ventilator vs. Incentive Spirometer

As I’m sure you’ve been reading, some with severe COVID-19 require ventilators. Unfortunately, the statistics with ventilators are dismal. According to a recent study of 5700 COVID-19 patients in the New York region, 88.1 percent of patients died (5). Hospitals are trying alternate approaches while using oxygen masks not ventilators, such as proning (turning patients on their stomach instead of lying on their backs in bed) and having them sit up in a chair in order to help with oxygenation in the lungs in those who have low oxygen saturation.

However, the ultimate exercise for the lung and the ability to improve oxygenation is an incentive spirometer. This device expands your lungs as you inhale. The more you do it, the better your lung functioning. One study, which I mentioned in previous articles on lung function, involved inhaling a total of 50 breaths a day which in two increments (6). 

The brand of spirometer used was a Teleflex Triflo II. This costs less than five dollars online at medicalvitality.com

What about incentive spirometer in sick patients? There was a small study with patients who had COPD exacerbations (7). Those who were given an incentive spirometer plus medical treatment saw a significant increase in the blood gases over a two-month period. Also, the quality of life improved for those using the incentive spirometer. 

Remember, one of the factors that may be a sign that someone is at high risk for severe COVID-19 is very low oxygen saturation. If you can improve oxygen saturation with incentive spirometer that is readily available, how can you pass this up? 

While it is tempting to gorge yourself with food that comforts the mind, DON’T! Foods that comfort the mind and the body protect you not only in the short term, but also the longer term from the consequences of chronic diseases.

Therefore, focus on DGLV (dark green leafy vegetables) that raise beta-carotene, which in turn lowers CRP. This can be achieved with diet by increasing consumption of beta-carotene-rich fruits and vegetables while limiting consumption of beta-carotene-poor ultra-processed and fatty foods. Interestingly, it is much easier right now to get DGLVs than it is to get certain ultra-processed foods. Add in exercise and an incentive spirometer and you will comfort your body plus your mind.

References:

(1) CNBC.com April 23,2020. (2) Front Immunol. 2018; 9: 1302. (3) Med Mal Infect. 2020 Mar 31;S0399-077X(20)30086-X. (4) Medicine & Science in Sports & Exercise. Online April 17, 2020. (5) JAMA. 2020 Apr 22;e206775. (6) Ann Rehabil Med. Jun 2015;39(3):360-365. (7) Respirology. 2005 Jun;10(3):349-53. 

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.     

Memorial Day Celebrated in Northport in 2018. County Executive Bellone said he is requesting flags be able to be placed on graves to celebrate fallen servicemembers. File photo by Karen Forman

In a year when a world by a pandemic still attempts to acknowledge historical landmarks like the 75th anniversary of the Allied victory over Europe in World War II, County Executive Steve Bellone (D) said he strongly believes that Suffolk County’s volunteers can and should be able to place flags on the graves of those who served the country in the military.

“We are asking that there not be a blanket policy, that [the Under Secretary for Veterans Affairs] allow the national cemeteries to make the determination at the local level,” Bellone said on his daily conference call with reporters.

Bellone said he firmly believes the county can figure out how to place those flags safely. Further, he suggested that “we will put in the effort to make this work. This matters to us here.”

As for the update figures on the virus, the county executive reported that an additional 870 people tested positive for COVID-19, which brings the total to 41,353.

As of yesterday, the number of hospitalizations decreased by 16 to 703, which is “good news,” Bellone said, with the number of people in Intensive Care Unit beds declining by 43 to 258.

“That is a great number,” Bellone added. “That’s a number we’re happy to see go down significantly.”

At the same time, however, the virus continues to claim the lives of more residents of Suffolk County. In the last day, an additional 29 people died from complications related to coronavirus, which brings the total to 1,597.

“To all of those who have lost loved ones to this virus, we are thinking of you and we are with you in Suffolk County,” Bellone said.

Bellone’s office distributed 51,000 pieces of personal protective equipment yesterday.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Stony Brook Closes Satellite ER

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

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

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

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

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

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

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

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