On the Line with TBR

Adrian Popp

Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, spoke with TBR Newspapers to discuss the current state of vaccinations in Suffolk County, the return to school in the fall, workplace issues, and tic-borne challenges for residents. Please find below an abridged version of the interview below. If you’d like to listen to the entire interview, view the video above.


TBR: How close are we to the 70% threshold for herd immunity to COVID-19?

Popp: We were hoping vaccination would start rolling out pretty fast and actually that happened. Over the last several months, more and more people got vaccinated. Right now, it’s open more or less like just show up and you can get a vaccine. You don’t even need an appointment anymore. The number of people vaccinated in Suffolk County is, percentage-wise, around 55% of eligible persons.

TBR: What about the rates at which people are seeking the vaccines? Has that slowed?

Popp: The number getting vaccinated has somewhat plateaued. The most eager people who wanted to get vaccinated did. Now, we’re seeing people who are actually still willing to get vaccinated and doing it and also some of people who are on the fence getting more information and speaking with other people who actually received the vaccine. More and more people are getting confident that the vaccine is safe, efficacious, and I hope this trend will continue.

TBR: What about schools in the fall? Will students return without masks and at full capacity?

Popp: At this point, the rate of coronavirus in Suffolk County is very low and has been decreasing since March steadily and is at almost a minimum even compared to last year. The question is, what will happen down the road? What will happen in the fall? We know that coronavirus has a propensity to be more active in cold environment. It’s hard to predict, because of these variants coming from different parts of the world. We should be hopeful that the fall will look good as long as more and more people get vaccinated. Hopefully, by September, we’ll reach about 70%, then going back to school will be easier.

TBR: As offices reopen and people return to work, how should companies handle rules, especially if some people aren’t vaccinated?

Popp: Offices vary in size, the number of people, how many are sitting in one room, close to one another. One has to make a decision on a case-by-case basis. Ideally, everyone working in one office should be vaccinated. It’s a difficult situation, mandating people to get vaccinated. It’s a fine line between your personal liberties and public policies.

TBR: When might a booster be necessary?

Popp: The need for the booster is being debated [as] the efficacy of the vaccine, the immunogenicity of the vaccine is probably higher than what I expected to see. From the early stages of December, we do find that they hold their antibodies quite well. The expectation is that this could last maybe two years or so. We don’t know that yet. One has to give it time and really find out.

TBR: What about weddings?

Popp: The wedding situation is quite a big situation. A lot of people have postponed the wedding in the hopes of having a real thing later on. The approach people have taken varied from A to Z. There is no cookie-cutter way to say this is the right thing to do and that’s the wrong thing to do. A friend of mine getting married is asking every person to be vaccinated. If you’re not vaccinated, you’re not allowed in the wedding. This is the decision of the groom and bride. Other venues are obviously more open, and they invite everybody and so forth. In the end, you have to be comfortable with the decision you make and you’re going there to have fun, you can’t have fun and celebrate if you’re truly nervous.

Tick-borne diseases

TBR: What about tick-borne diseases? Is there messaging people should keep in mind?

Popp: In the last three years, I have seen more tick-related diseases than before. We’re not talking only Lyme disease, could be also babesiosis, ehrlichiosis, and Rocky Mountain Spotted fever. Rocky Mountain Spotted fever used to be very unusual on Long Island. Now, we do see cases. I have already seen cases this year. When you go somewhere walking or hiking in some woods or meadows that may have ticks that may be around there, what you do at the end of the day when you come home, you get your shower, do a body check. Have someone else look at areas you can’t see well on your back, back of your legs.

Clinical Assistant Professor of Medicine at Stony Brook Medicine, Dr. Miguel Saldivar, wants residents to make vaccine decisions based on scientific information, rather than Internet speculation. Saldivar, who joined Stony Brook just months before the pandemic hit Long Island, sees improvement in the overall infection numbers, which have declined in recent weeks to about two to three percent from closer to five to six percent. In a wide-ranging interview (which can be seen online at tbrnewsmedia.com), Saldivar answered a host of questions.

TBR: Do you have any concerns about the number or percentage of people who are not lining up for vaccination?

Saldivar: In general, what we are more concerned about is the amount of misinformation that is out there. If you go on social media — if you go just on the internet, period — there’s a lot of people who are spreading lot of information that is really frankly inaccurate.

TBR: What are Stony Brook and others trying to do to counter misinformation?

Saldivar: There are a number of things we hear fairly frequently, probably the more common one I personally have heard, because Pfizer and Moderna are based on mRNA technology, everybody hears the term RNA and is worried that it’s going to change my genetic code and turn me into a mutant or cause a disease down the line. The first thing to understand about that, the way both of those vaccines work, it’s a set of instructions being given to the body cells, the moment it’s been delivered, the mRNA dissolves. It has no way of getting into the deeper part of the cells to change your genetic code.

TBR: Black and brown communities have a distrust of the federal government after some well known problems regarding Tuskegee Experiment and other issues. Is there broader acceptance now compared with a month or two ago?

Saldivar: Statistically, if you compare how this disease has affected minority communities, the risk of a severe outcome, hospitalization intubation and death is almost universally higher among minority communities. That has a number of factors, not just the disease itself. It’s also the fact that within those communities, it is more frequent to find some of the risk factors, meaning diabetes, obesity, preexisting pulmonary disease so on and so forth … What I have been personally involved with is reaching out to the community, we have found a lot of community centers have been very ready and willing to engage in a conversation. We have found places of worship to be wonderful places to have that conversation

TBR: What does the data tell you about the pandemic?

Saldivar: The last numbers I heard from the meeting this morning were between two to three percent positivity. We’ve been there for a week. Before that, we were staying pretty stable at like five to six percent or thereabouts. It looks like finally, this may be the effect of the vaccine, the numbers are finally starting to little by little trend their way down. We’ve been cautiously optimistic. There seems to be a little bit of a light at the end of the tunnel.

TBR: You have a bachelor’s degree in classical guitar performance. How did you wind up in infectious disease?

Saldivar: Through the nonprofit circle, I landed a job with the medical center at UCLA. That’s where I met a very, very good friend and mentor. She was key to helping me shape the path. I feel incredibly lucky to be part of this profession.

Photo from SBU (copyright ©2013 Warner Bros. Entertainment Inc.) by Drew Fellman

Stony Brook University Distinguished Professor Patricia Wright wants you to visit Madagascar, virtually for now and in person in the future. Wright, an award-winning scientist who has spent over 30 years studying the lemurs of the island nation of Madagascar, has been encouraging virtual ecotourism to the island nation, which has been struggling economically amid a pandemic that halted tourism. Wright recently raised money to support continuing operations for Centre ValBio, a research station she built in a national park she helped create. She has also helped secure money to create the nation’s first canopy walkway. The award-winning professor discussed COVID-19, conservation and science in Madagascar.

TBR: How has Covid affected Madagascar?

Wright: I flew back in January just after New Year’s. The Madagascar I saw was a lot different from New York. They have been able to stave off Covid by not allowing people into the country. It’s an island nation. There’s only one international airport. It was in some ways, a little bit better than in New York because there was less Covid. However, economically, it was a disaster because much of the gross national product for Madagascar is tourism and there has been absolutely no tourists there, and no researchers, either.

TBR: Has the government provided some support to bridge the gap?

Wright: It’s a real problem, because it’s the third poorest country in the world. The government doesn’t have a lot of funding. We’ve been asking for funding from the United Nations, from the World Health Organization, from the international agencies and they’ve been able to give some stop gap funding.

TBR: Does this crisis become worse with each passing week?

Wright: This is what I worry about because families were telling me when I was in Madagascar that they don’t have money to buy the seeds to plant their crops. That means that it’s not only right now that they don’t have enough money, but if they don’t plant the rice, they’re not going to have enough rice to eat. It’s reaching a crisis. Stony Brook has really pitched in … We have virtual wildlife tours, where people can go to Madagascar and our tourist guides will take you to Ranomafana. That’s adding income. People are taking their families to Madagascar by just doing zoom.

TBR: Does it look like tourists will return to Madagascar soon?

Wright: We’re hoping that that will occur in June or July of this year. That’s what the hope is, that this will start. The international airport right now is closed. That’s a good thing because that means that there’s not as much Covid coming in … When enough people get vaccinated, you’ll probably have to show your vaccination card if you want to get on a plane.

TBR: Are people booking trips?

Wright: I have a ticket to go at the end of May. Air France and Ethiopian Airlines are booking tickets for May, June and July. There’s hope.

TBR: You mentioned the virtual tours that people are taking. How many people are taking those tours?

Wright: A couple of hundred a week, and particularly because we’re also tapping into schools. A teacher can bring a class to Madagascar … Families can have a family reunion going to Madagascar all together. It’s interactive.

TBR: Are people seeing the same things they would see if they were on site?

Wright: They have some really great footage. They can get much closer to lemurs than if you were underneath them looking up in real life.

TBR: Do you hope people will follow up with an in person visit?

Wright: I’m hoping we’ll get a big increase in tourism once everything opens up

TBR: What about conservation?

Wright: It’s really difficult because people think that because the nation is shut down from the outside world, they can just go in and hunt. They can go back into protected areas because there’s not tourists there. There’s a real threat. We’ve been able to continue our programs in education and health and reforestation.

TBR: Are you concerned that some of these species might become extinct?

Wright: I really worry about that. There are some species of lemurs where there’s only 50 left. … We have 113 species of lemurs. They are in every part of Madagascar. It’s hard to protect them all, each one is so individually different. Lemurs have been evolving for 55 million, 60 million years. They’re only found on Madagascar. If we lose them, we really lose a part of our primate history that is very precious.

TBR: Is there any thought about capturing them and protecting them in an enclosed space?

Wright: We have thought about that. There has to be a long term program, though. If you bring that many animals into captivity, you have to be sure you have the funding to keep them fed and well protected. We have been thinking about that. We’ve been doing some translocations, where we take them from a place where they’re really threatened and they’re eating crops and farmers don’t like that. We take them out of that very dangerous situation and bring them into a protected area.

TBR: Are there funders that recognize this is a time where they can do the most good?

Wright: We do have some foundations that are stepping up, but we need more to step up … I just received a grant from the Leakey Foundation, which is out of San Francisco, and they just gave us money to keep the lights on for another three months. We are working hard to keep going.

TBR: How can people help?

Wright: I’ve already mentioned virtual tours [which cost about] $30 a person. For donating, we have a donation button at Centre ValBio. This is through Stony Brook and Stony Brook is very good about making sure the money goes straight to Centre ValBio, which is the name of the research station.

TBR: What about the science side?

Wright: I just got off a Zoom call with the sifaka guys … With the Covid year, we have a beautiful database, now we’re able to mine that, which consists of the plants and animals that are in Ranomafana. We’re making a relational database [that has over] 35 years of data that we’ve been taking from all over the region. It’s one of the few long term databases that there are in the tropics and we’re very proud of that.

TBR: Will the public be able to access some of that data?

Wright: Yes, we’re not at that point yet, but that what’s what we’re hoping for … We just heard news that we’re going to have a canopy walkway, which we have been wanting to put into Ranomafana National Park for over a decade and the funding has just been found. And so, we are going over to Ranomafana in May/ June with a designer to put in that canopy, so we’ll be ready for the tourists when they come, so they can go up in the canopy and see the lemurs eye to eye, to be able to see those chameleons and birds and everything in a new way.

TBR: Who provided the funding?

Wright: It’s called Mission Green and the organization is raising money just for canopy walkways, there will be 20 canopy walkways. This will be the only one in Madagascar.

TBR: As far as the sifaka call you mentioned earlier, is there any news?

Wright: So far, we know that all the babies from last year have survived. We’re kind of at that stage right now. That’s very exciting. The babies will be born in May and June.

TBR: What did you notice that was different in the Covid world of Madagascar?

Wright: When we went out there without being there for six months, because the national parks were closed. When we did get to go out there, I couldn’t believe it. They came down and were [practically] saying, ‘Where have you been?”

Sen. Gaughran in his office in August. Photo from Gaughrans office

State Sen. James Gaughran (D-Northport), chair of the Local Government Committee and member of several other committees, spoke with TBR News Media newspapers on Friday, March 12, to discuss his concerns about allegations of a cover-up of nursing home deaths from COVID by Gov. Andrew Cuomo (D), vaccinations, bodycam usage by police and a full return to school in the fall. Please find below an abridged and edited version of the discussion.

TBR: Are the nursing home issues [related to Cuomo] worrisome to you?

Gaughran: Oh, absolutely. We are very concerned about them. The State Senate is actually going to be holding hearings. In addition to hearings that already have been held, we are absolutely going to get to the bottom line of what happened with the administration and what happened in the nursing homes. It is very disturbing, the reports of changes to records of misrepresentations. It is obviously being reviewed by the United State’s Attorney’s Office. It is very serious. There needs to be a full investigation there. Without interfering with their investigation, we are going to continue to, as a Senate, look as deeply and carefully as possible, making sure that people are held accountable who need to be held accountable.

TBR: What about reports of a possible cover-up by the governor and his office?

Gaughran: That’s going to be, has been and will continue to be a major part of our investigations moving forward. The first priority is making sure we are fixing the problem moving forward. The second part is making sure everybody is being held responsible … You have the other issue that there were reports that were submitted by the Health Department concerning some of the nursing home numbers that were then amended or tweaked by the executive branch before they were released. That is being investigated as well … They are saying that’s part of the normal process [that the] executive branch always before a report is finally issued will review it and make tweaks. That’s fine if we’re talking about grammar and language and even tone perhaps. Based on the circumstance.

TBR: What is it about now that has produced sufficient evidence to give people like you who are part of the Democratic party the initiative to say, ‘It’s time.’ What brought this critical mass to democrats to ask Cuomo to step aside?

Gaughran: The nursing home issue has been extremely disturbing and we have been addressing that for quite a while. The numerous allegations that have come out from a variety of individuals, women, and these are credible and very serious and very disturbing allegations. I believe it is vitally important that they be treated that way. I have the utmost confidence in New York State Attorney General [Letitia] James to make sure that, number one, she is giving every single person coming forward the opportunity to be heard … [she will] obviously follow the facts and whatever the final determination is and recommendations are, that will come out of her report. Simultaneously now, we have the New York State Assembly, through the judiciary committee, which happens to be chaired by my colleague [Charles] Lavine who represents part of my district, they have an obligation under the New York State Constitution to conduct the investigation, because the impeachment process begins with the state Assembly … Whether or not they decide to issue articles of impeachment, that will be up to them … In the event they do, it then goes to the state Senate, where members of the state Senate will serve as jurors, alongside nine members of the New York State Court of Appeals.

TBR: With the government focused on Cuomo, is there any concern that politicians aren’t protecting people in New York?

Gaughran: The big issue is we have to adopt the budget … That impacts everything we’re doing as it relates to Covid, including rolling out the vaccines, making sure as much money as possible [gets] the economy moving again, [providing] assistance to small business, [and] implementing the federal funds, the unrestricted funds that are coming to the state. We have to implement those funds through the budgetary process. We also have to supplement them to some extent because not everything is covered by federal money.

TBR: Gov. Cuomo was present at your first swearing in as a state senator. You’ve worked with him in the past. Is this a difficult position for you to be in to ask him to step aside?

Gaughran: Obviously, it is difficult because I’ve known the governor for quite a while, and the governor has done a lot of great things for this state. I knew his father very well. He was one of our greatest governors. It is extremely difficult, but you know, my obligation is to the people I represent in the district and the people of this state to try to do what is in the best interests of everybody moving forward. It is not something that doesn’t bring me a lot of pain … The allegations that have been made that are very credible from members of the executive chamber and others have to be fully reviewed.

TBR: Have you scheduled your own vaccination?

Gaughran: I did make the cut in the people who have preexisting medical conditions because I do have severe asthma. [I’ve] been treated for [it] since I was a teenager. I take three different medications a day for that. I went online and it took me about a week. I was able to get my vaccine in Utica, which is about an hour and a half outside of Albany.

TBR: Have you seen County Executive Steve Bellone’s (D) report and recommendations about policing?

Gaughran: I have not read the report. I have seen some news accounts of it. I believe that this whole process is a very healthy process … Having some very difficult conversations, I think that’s good. On the issue of bodycams, I voted to require bodycams for all members of the New York State police … Many police officers said to me that they like wearing them as well, it gives them protection as to what the events were that took place to the extent that the bodycam is able to show that it’s obviously an important tool

TBR: How do you think education will look this fall?

Gaughran: I fully expect us to have everybody back in the classroom in the fall.

Adrian Popp, chair of Infection Control at Huntington Hospital/ Northwell Health and associate professor of Medicine at Hofstra School of Medicine, spoke with TBR News Media newspapers to discuss vaccinations and COVID-19. Please find below an abridged and edited version of the discussion.

TBR: Why do some people have a stronger reaction to a second shot?

POPP: These two vaccines are very well tolerated. Yes, there are some side effects after getting the shots. Indeed, even in the trials, it has been shown that the second shot is sometimes more prone to have side effects. There is pain, tenderness at the site of the shot. Sometimes people can get fatigue, fever and even a chill. It is rare to have something more severe than that … From my experience, most people tolerate them well, including the second shot.

TBR: Should people try to take at least a day off, if they can, after the second shot?

POPP: That is not necessarily unreasonable. A lot of my colleagues did take the shot later in the afternoon and then go home and rest for the evening. If you can afford to have a day off the next day, that’s probably not unreasonable.

TBR: Does having the vaccine free people up to interact with others?

POPP: What we know from the Moderna and Pfizer trials is that the effectiveness of the vaccination is 95 percent to prevent symptomatic disease … Can a vaccinated person develop a light form [of the disease]? In theory, yes. There are not completely safe in [not] transmitting the disease to someone else.

TBR: Have the Black and brown communities, which have been somewhat resistant to taking the vaccine, been included in the clinical studies?

POPP: Those studies with Pfizer and Moderna included these populations. They are well represented in these studies. There’s no significant difference in the side effects in African Americans, or less efficacy in the Black and brown communities …. [The Black and brown communities] should feel comfortable that it’s as safe or as efficacious as it is in a Caucasian person.

TBR: Have people from the Huntington Hospital or Northwell community asked you about the safety of taking the vaccine?

POPP: I do have conversations like this every day with different members of Huntington Hospital [as well as] the community at large … I bring up one very recent study that will probably help in kind of showing a few things. I’m going to bring in Israel, a smaller country with a centralized health care system that has been very good in vaccinating people …. More than 50 percent of their population has received the COVID vaccination. Specifically, the senior population, 65 and above, has received the vaccine in percentages even higher … In a study in the New England Journal of Medicine of more than 600,000 people who received the vaccine, [they] compared the incidence of COVID without the vaccine. They found the protection is more than 90 percent … That tells us the vaccine is very effective.

TBR: What do you hear about the Johnson & Johnson vaccine?

POPP: The best thing about the [J&J] vaccine is that it’s only one shot and the second thing is that it can be stored at normal temperature compared to the other vaccinations [which require deep freezing] … That allows it to be distributed more easily … It will probably be a good vaccine as well.

TBR: After the shots, what is the immunity?

POPP: After the first shot, approximately a week or two weeks after the first shot, you develop quite a significant level of antibodies. There is a certain amount of protection. With the second shot, the level of antibodies shoots up probably 10 times higher than after the initial shot … Full immunity is one week after you receive the second shot.

TBR: Some reports suggest that people who have COVID and develop antibodies may only need one shot. Is that true?

POPP: There are infectious disease experts looking into this. We do know that after getting COVID, you do develop a certain level of antibodies … That varies widely from person to person … The jury is still out on this one. Truly, we have to look at it in a more scientific way. We’ll find out if this will be an option down the road. At this point, as the recommendation stands, you do have to get both shots, even if you had COVID disease before.

TBR: Do we know more about why one person gets very sick and another has only mild symptoms?

POPP: Up to 50 percent of people who get COVID are either asymptomatic or have really minor symptoms. There are risk factors for developing a serious disease. We know that obesity, hypertension, diabetes and specifically certain immunocompromised conditions are risk factors for more serious disease. I have seen older people in their 90s who do have a mild form of the disease, then I’ve seen somebody in his 40s who has very severe disease … There is no real good way of saying who will develop a more severe disease versus somebody else who will have a milder form.

TBR: What about the aftereffects of COVID?

POPP: I have seen quite a few cases of people who … develop quite severe symptoms. On the milder end, people have a loss of taste and smell. This can last for some time … From my experience, most people will recover from this. On the other hand, people with more severe illness, people who get hospitalized, I have to say that the virus can take a significant toll on that person. I have seen patients who have lost 20 to 40 pounds over a period of a month or a month and a half … Recovering from such a hit of being sick for such a prolonged period of time takes a toll on people. Some patients also develop some degree of cognitive impairment.

TBR: What keeps you up at night?

POPP: Even though [the infection rate] is coming down in New York, it is still not insignificant. It’s still an issue. Until we get … a significant number of our population vaccinated, we’re still going to be in trouble … The only way we can stop the whole thing is by vaccinating as many people as we can.