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By David Dunaief, M.D.

Dr. David Dunaief

COVID-19, a strain of the coronavirus, is now a pandemic. I have been barraged with questions from patients, neighbors and friends. They are right to be asking questions, because there is not enough information being circulated about how to protect yourself and your family. 

Key elements

The key weapons we have in this fight against COVID-19 are containment and mitigation. A lot has been shared about containment by the Centers for Disease Control. Containment is reducing the incidence of new cases to a goal of zero, thus flattening the prevalence curve so this virus is no longer infecting anyone. This requires social distancing, hand washing for at least 20 seconds, surface cleaning, and avoiding touching your eyes, nose and mouth (1). If you have not already, I encourage you to review the guidelines at www.cdc.gov/coronavirus.

There is less information being provided about how we can minimize the severity of the disease if we are infected. This is mitigation. Mitigation is about preparing ourselves, so we experience an asymptomatic or a mild form. 

Who is most at risk?

According to a study focusing on Wuhan, China findings, people most at risk are those who have chronic diseases, with high blood pressure, diabetes and heart disease being the three most common (2). Also at risk are those who are “older,” that is 60 years or older, for they are more likely to have weakened immune systems and increased inflammation.

Managing your immune response

Ultimately, the goal is to have a healthy, appropriate immune system response. If the immune system “under-responds,” the virus’s symptoms will be more severe. Another term for this is immunocompromised. 

If the immune system is overstimulated, your white blood cells are more likely to attack healthy tissue and cause further damage, exacerbating the situation. This sometimes happens after a heart attack, where the immune response is overzealous, targets healthy tissue and causes dysfunction in the heart. This process is called remodeling.

The goal is to create a healthy/strengthened immune system — not to boost and not to suppress the immune system. You want the “Goldilocks” of immune responses: not too little, not too much, but just right.

What can be done?

The best methodology here is to lean on what I call the four pillars of lifestyle modification: diet, exercise, stress management, and sleep.  

Diet. By implementing a nutrient-dense, whole food plant-based (WFPB) diet or, more specifically, what I call a “Low Inflammatory Foods Everyday (LIFE) diet,” you can rapidly improve or even reverse these chronic diseases, decrease inflammation and strengthen your immune system, which will decrease your chances of dying from the virus.

The Lancet study referenced above found that inflammation and a weakened immune system were central to determining how people will do on entering the hospital.

What I’ve found with the LIFE diet in my practice is that people have white blood cells that are on the low end of the scale, between 2.5-4.5, rather than in the middle or upper range of 6.0-10.8. Typically, my patients’ white blood cells when they get sick stay within the normal range of 3.4-10.8. In fact., I had a patient who recently got a cold virus: their white blood cells were 3.4 before they got sick, and they rose to only 7.8, well within the normal range. This resulted in a targeted response with recovery in a very short time period. 

For those with healthy immune systems, if they do get the coronavirus, their response will be more likely targeted instead of a disproportionately large response that starts killing the virus but also the healthy tissue in the lungs, leading to increased inflammation and fluid build-up in the lungs. Dr Fauci has warned this could potentially happen – what is called a cytokine storm – although the chances are very small. Ultimately, the immune system in these situations contributes to the problem, instead of helping.

So, what can you do to incorporate LIFE diet habits into your daily routine?

Focus on fresh and frozen fruits, vegetables and legumes. This is very important. With vegetables, the focus should be on dark green leafy vegetables, such as spinach, bok choy, kale, broccoli and cauliflower, as well as mushrooms. More is better. You cannot have too much. For fruits, apples have shown to play an important role in lung health, and all types of berries have high anti-inflammatory effects. 

WFPB diets ultimately help with inflammation and immune strengthening and also support reduced stress and better sleep. The reason for these effects may have to do with the microbiome, the microbes living in your gut, which are an important determinant of how your immune system functions. Seventy percent of your immune cells are in your gut.

You can test for inflammation by looking at both white blood cell count and high sensitivity CRP (hsCRP). Beta carotene levels in the blood are a way to measure nutrient levels. I recently published a study that showed there is an inverse relationship between beta carotene in the blood and inflammation measured through hsCRP. This showed a 75 percent reduction in inflammation with higher beta carotene levels achieved through a plant-rich diet focusing on dark green leafy vegetables.

Interestingly, you don’t seem to achieve the same reduction in inflammation from vitamins or plant-based powders as you do by eating actual fruits and vegetables and legumes.

Stress management and exercise. Please, don’t panic. When you stress, your body releases cortisol, or internal steroids, that actually weaken the immune system and increase your risk of serious infection. Techniques to reduce your stress include exercise, yoga and meditation.

Mild to moderate exercise can be effective, such as a walk or jog outdoors or up and down the steps of your home. Just because the gyms may be closed in your area does not mean you can’t get exercise. It is spring, let’s take advantage of the weather, which will also help with mood and stress.

You can also exercise your lungs using an incentive spirometer. My personal favorite is the Triflo II version, but there are many on the market. I recommend taking 10 breaths using the incentive spirometer twice a day. This can help expand your lungs and keep the aveoli healthy and open. Aveoli exchange oxygen and carbon dioxide molecules to and from the bloodstream.

Sleep. Exercise will also help with sleep, as will the LIFE diet. Getting enough quality sleep is important to strengthening the immune system. Quality, not quantity, is most crucial. 

What if you are infected?

If you are infected, supportive care is most critical: stay hydrated; focus on foods with fluids in them to help with this, like fruits, vegetables, and low-salt vegetable-based soups; and sleep.

Importantly, stay away from NSAIDS. These are mostly over-the-counter medications such as ibuprofen, naproxen and even aspirin, but can be prescriptions such as diclofenac. These suppress the immune system, thus making it more difficult for it to fight (3)(4). The mechanism of action for this suppression of the immune system is an anti-inflammatory effect that is different and detrimental, compared to the favorable anti-inflammatory effects of a WFPB diet such as the LIFE diet.

Instead, you want to reduce fever using acetaminophen, or Tylenol. This will not have any effects on inflammation, thus not interfering with the body’s immune system. If you can’t tolerate acetaminophen for fever, some alternatives may be elderflowers, catnip (which is a gentle choice for children), yarrow, white willow bark, echinacea, and lemon balm, although there is little data on their effectiveness.

Do not hesitate to go to the hospital if you have difficulty breathing, persistent pain or pressure in your chest, new confusion or an inability to get up, or bluish lips or face. These are signs of potentially severe and life-threatening COVID-19 symptoms.

To sum it all up, chronic diseases and not managing those four lifestyle pillars are risk factors for dying from COVID-19. You can improve or reverse your chronic diseases, as well as strengthen your immune system and reduce inflammation through a plant-rich dark green leafy vegetable diet like the LIFE diet

References:

(1) cdc.gov/coronavirus. (2) Lancet. Published online March 9, 2020. (3) Lung. 2017;195(2):201-8. (4) Chest. 2011;139(2):387-94

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.       

 

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Setauket Presbyterian is among the houses of worship offering services online. File photo

While local religious leaders hold on to their faiths, they are still practicing an abundance of caution during the COVID-19 pandemic.

In a March 16 email, the Diocese of Rockville Centre directed all parishes to suspend or postpone all Masses, meetings and nonessential activities until April 14. The suspension tentatively will end after Easter Sunday, which is April 12. The postponements also include confirmations and first communions, while funerals, weddings and baptisms will be permitted if necessary and must be limited to less than 50 people.

“We are encouraging everyone to pray from home and to use this opportunity to develop our personal connection with G-d.”

— Rabbi Motti Grossbaum

Worshippers will be able to pray at local Catholic churches at the discretion of the pastor. However, the number of people must be under 50, in accordance with the New York State mandate.

The diocese said in the email that the Catholic Faith Network will provide televised and online Masses, and alerted Catholics that local parishes may also offer live streaming.

Other faiths are following suit.

Village Chabad Center for Jewish Life & Learning in East Setauket last week canceled several events and programs, according to Rabbi Motti Grossbaum. While last week’s service incorporated distancing of worshippers with 6 feet of space in between each of them, the Chabad has now canceled services until further notice, Grossbaum said, “as health and well-being supersede everything else in Judaism.”

Grossbaum said Chabad’s preschool and Hebrew School have also been closed in line with the state’s two-week mandatory shutdown, and the center is offering online classes and videos for children and adults during the temporary closure.

“We are encouraging everyone to pray from home and to use this opportunity to develop our personal connection with G-d,” Grossbaum said in an email.

“We felt like the best thing was not to have people gather, especially since technology allows us to do something where we can still reach people.”

— The Rev. Kate Jones Calone

The Rev. Kate Jones Calone, interim pastor of Setauket Presbyterian Church, said services have been moved online. On March 15 she said it was just her, a liturgist and a couple of musicians live streaming from the sanctuary using Facebook Live.

She said the board, which consists of congregants, took into account recommendations from the town and health organizations.

“We felt like the best thing was not to have people gather, especially since technology allows us to do something where we can still reach people,” the reverend said.

Setauket Presbyterian is also using Zoom, a video conferencing platform, for church meetings and confirmation classes.

“This is something that I think we are all dealing in a very unprecedented way,” she said.

Jones Calone added the staff is reaching out to parishioners to see if there is any help that they may need as far as running errands and are hoping to identify other ways they can help the community at large.

“From a theological standpoint, we know that connections are there whether we’re together or physically apart,” she said.

The reverend likened following the current health guidelines as similar to loving our neighbors, and she said she hopes everyone will reach out to their loved ones and neighbors as best as they can.

“Not only are we taking care of ourselves but also social distancing and things like that help us make sure we’re loving our neighbor,” she said.

“I will miss worshiping with you all on the Sundays ahead, but hopefully with these measures we will all remain safe and able to continue worshiping together well into the future.”

— Pastor Chuck Van Houten

Stony Brook Community Church Pastor Chuck Van Houten emailed members March 14 saying all churches in the New York Annual Conference of The United Methodist Church were requested to close for at least two weeks.

Van Houten said in the email that SBCC would make worship services available on its website. The services would most likely be recorded the night before and only a few people would be on hand. The church also plans to set up a Zoom account to continue meetings over video conferencing.

“I will miss worshiping with you all on the Sundays ahead, but hopefully with these measures we will all remain safe and able to continue worshiping together well into the future,” Van Houten said.

Rabbi Aaron Benson of North Shore Jewish Center said in an email the synagogue will be operating remotely like other institutions in the area.

“Perhaps one of the more interesting developments has to do with prayer life,” Benson said. “As communal prayers require being in person, Jews nevertheless can continue to pray individually.  The opportunity then, to develop one’s personal spiritual practices and closeness to the Divine may be one of the only positive outcomes of our current state of affairs.”

When it comes to the current situation, Benson said it’s important to remember to have a thoughtful, grateful and kind attitude toward others.

“‘Receive every person with a smiling face.’ This piece of ancient rabbinic wisdom might seem out of place in a time of social distancing and quarantines, but I can’t imagine a more germane piece of advice,” Benson said. “If you’ve been in the stores lately, it can be a bit of a madhouse. If you’re stuck at home for days on end even with your family, if you’re dealing with poor internet connections for your remote meetings — patience and thoughtfulness can be at a premium. This is why in trying times like these remembering to have a thoughtful, grateful, kind and caring attitude toward others can make even more of a difference than an extra roll of toilet paper.  So whether it’s in person or just in your voice over the phone, be sure to have a smile.”

All houses of worships have asked that congregants check their websites and social media for live streaming of services as well as updates of when they will open again.

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The Huntington-based Main St. Board Game Cafe has had to let staff go in the hopes of surviving. They are still selling board games to-go. Photo from Board Game Cafe Facebook

By Kyle Barr and Leah Chiappino

As Monday rolled around this week, and as local businesses were looking to find ways to attract customers during the ongoing coronavirus crisis, a new order handed down by New York State put most of those considerations on hold.

On Monday, March 16, Gov. Andrew Cuomo (D) ordered many nonessential businesses to shut down, or in the case of restaurants, to lessen foot traffic and only allow takeout orders and deliveries.

PJ Cinemas has closed due to the state’s coronavirus mandates. Photo from Google Maps

“Our primary goal right now is to slow the spread of this virus so that the wave of new infections doesn’t crash our health care system, and everyone agrees social distancing is the best way to do that,” Cuomo said. “I have called on the federal government to implement nationwide protocols, but in their absence, we are taking this on ourselves.”

New York State, Connecticut and New Jersey will all be limiting social meetings of any sort to 50 people. Movie theaters, gyms and casinos were closed starting at 8 p.m. Monday.

The governor also announced restaurants and bars will be closed to sit down service and would need to refocus on takeout.

PJ Cinemas already announced closure until they, “receive further guidance from state, local and federal authorities.” All ticket sales will stay valid until they reopen.

Local elected officials said the restrictions were due to people’s reports that numerous bars had high activity over the weekend, despite warnings.

“We are discussing ways to make sure that it is enforced,” said Suffolk County Executive Steve Bellone (D). “We expect bars and restaurants will comply … by and large we’ve had great compliance from people.”

Businesses and local business groups took the news with a mix of understanding and worry. Most understood the reason why the state has taken such drastic measures but could hardly fathom how this might impact them long term. The change could not just mean shuttered businesses for the next few weeks, but permanent closures.

Jennifer Dzvonar, the president of the Port Jefferson Station/Terryville Chamber of Commerce, said local businesses are the “lifeblood of the community,” and times such as these require the community to come out in support, whether it’s ordering takeout from restaurants or buying vouchers or gift certificates.

The difficulties will be severe. As people are asked to stay home, some away from work, less will have money to spend. She said service businesses, including plumbers, carpenters and the like, will be hard hit since less have the money to spend.

Jennifer Dzvonar, the PJS/T Chamber president, said local businesses will be hit hard by the state mandates. File Photo

“Businesses need as much positive reinforcement as possible,” Dzvonar said.

She added businesses also often sponsor Little Leagues or other community events, so while the governor’s order is in effect such groups may have to go without for the time being.

Other chamber leaders in the area wrote quickly to members to try and offer assistance. 

Gary Pollakusky, the president of the Rocky Point Sound Beach Chamber of Commerce, said he is especially worried about businesses shutting down permanently. 

“When we look at our small businesses as the lifeblood of our communities, we should be focused on our mom and pop shops, more than ever in this time of need,” he said.

Jane Taylor, the executive director of the Three Village Chamber of Commerce, said restaurants providing takeout meals is a good bridge until business returns to normal, but, “There is no question that our local businesses and restaurants are going to face challenges.” 

Northport Chamber of Commerce President James Izzo says the impact of the restrictions on the village could be devastating.

“Small businesses especially are trying to keep their [employees] paid, and it’s difficult to do that with no money coming in,” he said.

He added most village restaurants are trying to focus on takeout, removing or making their seating inaccessible. Most are trying to deliver food, which can be expensive.

“There’s two sides to this,” Izzo said. “You have some people who are afraid to come out who need food, need to eat and need supplies, and you have other people that want to come down, but everything is so limited. We have bars, but they don’t serve food, and you can’t have more than 10 people in a space, so that’s a done deal.”

Some boutique stores are open, but most are trying to supplement the lack of foot traffic with online shopping.

Izzo said that the village was quiet with minimal traffic Tuesday afternoon, while Sunday was busy with foot traffic.

“You can’t make a living one day a week,” he said. “We are a seasonal community and businesses depend on this time of the year after a long cold dark winter.”

He said the mood in the village is still hopeful, though uncertain.

“This is uncharted territory and everyone is trying to figure it out day by day,” he said.

Merchants are talking about using vehicles owned by the village to deliver meals to those in need. The chamber is working on providing advertising to businesses for free, to promote their delivery services or online products.

Izzo, a real estate broker, says the impact to his business has been minimal, stating most of his work is done online. Open houses have been slower than usual at this time of year, but not completely dead. However, he is anxious to see what this upcoming weekend will bring, in the wake of the new restrictions.

“This is uncharted territory and everyone is trying to figure it out day by day.”

— James Izzo

“A lot can change in six days, we will have to see what happens,” he said.

Copenhagen Bakery and Cafe has had to close its seating but is still open for takeout. The owner,  Flemming Hansen, says that most of the business is in takeout baked goods, and while the number of customers is down, there has been a steady flow of people purchasing breads and soups.

“So far we’re doing alright,” he said. “We’re taking it day by day.”

He added that cake sales have dropped, as people are not having gatherings.

Neil Goldberg, the owner of Main Street Board Game Café in Huntington, said the restrictions have forced him to lay off the entire staff in hopes of buying time.

“Nobody is going to make any money, it’s just about keeping the doors open,” he said.

The cafe’s purpose normally is to be a place where people can come in, socialize and play board games; however, they have had to eliminate all food services, besides prepackaged drinks and are only selling games.

“It’s not worth it for us to turn the ovens on,” he said.

He added the store had some purchases “from people who realize that they’re going to need more entertainment than just watching TV and watching the news.”

The cafe will offer curbside delivery of games and are looking to offer delivery services within a 15-mile radius in the coming days.

Goldberg said the local village businesses are checking in on each other and sharing advice and ideas.

“There’s no plan for this,” he said. “Nobody has insurance for this, because it doesn’t exist, and all you can do is lean on each other and hope things will improve.”

Despite all of this, Goldberg has seen moments of humanity. On Tuesday, former employees came in and bought games to help the shop stay afloat. Then, a mother, who has a son that plays in a game tournament at the shop, bought $1,000 worth of gift cards.

“That was really moving,” he said. 

Goldberg added the best way to support small businesses during this time is to patronize them as much as possible.

“Gift cards are good because, you will eventually use them and you are essentially providing a no-interest loan to the business that you like,” he said. “Honestly, the best thing that you can do is to stay socially distant so we can get through this quicker. Everything that everybody is doing is just Band-Aids at this point to a large problem, and the best thing for businesses is for things to go back to the way they were.”

Meanwhile, federal officials in the House and Senate are considering an aid bill to help workers. The U.S. House of Representatives passed a bill that would provide free testing, extend the unemployment payment period and offer paid sick leave and emergency leave for workers in companies with 500 or less employees. The latter could exempt companies with 50 or fewer employees if that measure would bankrupt the company.

President Donald Trump (R) has called for a $850 billion aid stimulus to major companies such as airlines impacted by the spread of the virus. The White House has also suggested deferring tax payments and even sending home checks to every American to cushion the blow of being out of work. As of press time, details have been sporadic, and the president’s office has flip-flopped on several initiatives already.

The Village of Port Jefferson declared a state of emergency March 16, after both the state and Suffolk County declared theirs. As of Tuesday, March 17, Village Hall and all village-owned facilities are closed to the public. Further board of trustee meetings will be held remotely, along with the budget presentation that was planned for March 30. The executive order only ends after a further order from the village mayor.

“The only thing we can do is ask residents to continue to support the local businesses.”

— Margot Garant

According to Mayor Margot Garant, the executive order allows code enforcement to enforce the new restrictions on businesses. 

“The only thing we can do is ask residents to continue to support the local businesses,” she said, adding those stores are “going to adapt, they will find means to keep those businesses viable.”

Barbara Ransome, the executive director of the PJ village chamber, said the chamber is working on a social media campaign encouraging takeout pickups and deliveries.

With nobody really able to say how long life will be disrupted because of COVID-19, the true consequences of this loss of business are still unknown. 

“My mother always used to say you can live with anything bad as long as you know it’s not long term, or you see it ending,” Ransome said.

Businesses, she said, are all hedging on when that end finally arrives.

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SBU student Caroline Klewinowski is just one of thousands impacted by the university’s new dorming mandates. Photo by Julianne Mosher

By Julianne Mosher

Amidst the COVID-19 health crisis that is shaking the world, Stony Brook University students are now being affected – especially those who rely on dorming on campus. 

At the beginning of what was ostensibly the start of spring break, dormer students were told they would have to leave campus. Photo by Kyle Barr

The last week has been turbulent, and for students the news has been changing daily. On March 11, SBU Interim President Michael Bernstein sent out an email to students telling them that classes were going to resume remotely after spring break. 

“Spring break (March 16-20) will commence as planned at the end of this week and we will begin remote instruction at the conclusion of the break,” the email read. “Accordingly, students planning to leave campus for spring break should take with them any items essential to continuing their education from home including laptops, textbooks, notebooks, essential papers and other material. Students should also bring home valuables and indispensable items in the event that a sustained period will pass before they are able to easily retrieve them.”

The email came shortly after angry and anxious students began protesting the administration, as rumors began to swirl among the student body. 

“Administration didn’t really communicate with us,” said Jeni Dhodary, a philosophy and economics major. “We didn’t get an official response until the day before spring break. … It’s a really messy situation.”

Since students were gearing up for their break, they were advised to go home and stay home, if they could, even though the dorms and some food spots would remain open on campus for students preferring to stay there.

Caroline Klewinowski, originally of Brooklyn, opted to stay in her dorm instead of heading home for spring break. 

“New York City seems like ground zero for coronavirus,” she said. “Long Island seems a lot safer.” The journalism major’s mother suffers from lupus, which was another reason she wanted to stay away from home. 

But then things changed and on March 17 the university sent out another email to students saying that on-campus housing will close and students must go home. 

Richard Gatteau, vice president for Student Affairs and dean of Students, and Dallas Bauman, assistant vice president for Campus Residences stated in another email the plans for students over the next several days. 

“All residents who live within driving distance of campus must vacate the residence halls and campus apartments as soon as possible, but no later than 5 p.m. on Thursday, March 19. All other residents must vacate as soon as possible, but no later than 5 p.m. on Friday, March 20,” it read. “Room and meal plan costs, where applicable, will be prorated for the remainder of the semester for all students leaving campus housing and applied as a refund and/or credit to your student account based on the date of checkout.”

At the beginning of what was ostensibly the start of spring break, dormer students were told they would have to leave campus. Photo by Kyle Barr

With an international student body that makes up about 18 percent of the university, those students are required to move out as well, since “Visa and Immigration Services will not terminate or shorten the immigration records for F-1/J-1 degree-seeking students who remain enrolled and depart the U.S. It is important to note that Customs and Border Protection has not provided updated guidance regarding procedures for reentry, including the five-month absence from the U.S.”

International student, Vaidik Trivedi, who lives off campus, was concerned about the initial reports of remote learning, but found comfort in having his own place not within the dorms — even though there are bans on going outside. 

“I don’t know what to do with my weekends now,” he said. “I think we need to deal with this logically, rather than focus on the mayhem.”

Trivedi added it was hard being on campus, with little communication coming from the administration and rumors spreading at a rapid rate. 

“The university created havoc … students didn’t know what was going on,” the 22-year-old said. “They could have communicated better with the students while the rumors caught on fire, especially with the international students. It was one week too late.”

Maria Tsapuik, a Junior Multidisciplinary Studies major is originally from Ukraine, which banned all commercial travel coming into the country March 17. The same day, Stony Brook shut down the dorms.

“I understand their decision to [close the dorms], but they should have told us earlier … before every country shut its borders and there is no way for us to get out,” she said.

She has filled out the form for an extended stay and is waiting for an answer from the university. If they do not grant her an extended stay,  she said she has someone to stay with.

While students are packing up to leave and find shelter in their homes away from the campus grounds, one thing all college students are feeling is a general sense of heartache that their year at school is being cut short. 

Frank Gargano, a senior, dormed on campus, but went home for spring break only to find out he had to drive back to school to pack up his room. 

“I’m half-mad that the housing money is essentially shot, and half-mad I can’t hang out with my friends as often as I could during my last semester,” he said. “I’m essentially robbed of my last semester.”

Even professors are feeling the changes coming to Stony Brook University, by placing their courses online with no physical student interaction. 

“It’s much less rewarding because I like to teach in a classroom and encourage students to speak up in class,” adjunct journalism professor Jon Friedman, said. “But I like to take on new challenges, and this is an enormous one.”

He added he feels badly for the students who are planning to graduate this May. 

“The last semester should be their happiest time and now they probably won’t be able to celebrate a normal commencement ceremony,” he said. “Throwing your cap in the air in triumph, in your backyard, doesn’t give a student the same kind of thrill.”

This post has been updated with additional reporting by Leah Chiappino

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Tents like the one above are being used during Stony Brook University Hospital’s drive-through testing for the coronavirus. Photo by Kyle Barr

Hospitals along the North Shore of Western Suffolk are changing the way they operate to keep the number of coronavirus cases down.

Stony Brook University Hospital

Stony Brook University is asking that all patients who have cold and flu-like symptoms to go directly to its emergency room department area and not get out of their cars, according to its website. Between 11 a.m. and 11 p.m., patients driving to the emergency department entrance will be greeted and screened while in their vehicles.

Stony Brook University’s Ambulatory Care Pavilion COVID-19 Triage area. Photo from SBUH

Those with cold and flu-like symptoms and mild respiratory symptoms will be directed by staff members to go to the hospital’s new triage area located in the nearby Ambulatory Care Pavilion. The triage area will be staffed by emergency medicine physicians and nurses.

According to Stony Brook Medicine, “The triage service is to separate patients with cold and flu-like symptoms from others seeking emergent care, in order to provide all patients with a streamlined environment for care and treatment.”

Dr. Eric Morley, clinical associate professor and clinical director of the SBU Renaissance School of Medicine’s Department of Emergency Medicine, said in an email the new procedure has been successful.

“The process has gone very well, and we are seeing an increasing number of patients in the triage and treatment area located in the Ambulatory Care Pavilion,” he said. “Our staff have adapted very well to the new process. The level of teamwork and dedication of our staff is clearly the driving force behind this success.”

He said doctors have seen patients with both cold and flu-like symptoms, and also those who fit the Centers for Disease Control and Prevention criteria for COVID-19 testing.

On March 18, a drive-through testing site for the coronavirus opened in the commuter P Lot on the southern end of the SBU campus. According to the office of Gov. Andrew Cuomo (D), those wishing to be tested must call 888-364-3065 to schedule an appointment. No referral from a doctor is needed but operators will ask callers questions such as age, symptoms, if they have any underlying health problems and if they have been out of the country. The information will be given to the New York State Department of Health, which will call back with an appointment confirmation if testing is deemed necessary.

SBUH has revised its visitors policy. In response to New York State declaring a state of the emergency due to COVID-19, the hospital will no longer allow visitation until further notice.

“While we understand the important role that family members and visitors play in a patient’s healing process, this is a necessary step we need to take at this time for our adult units,” a statement from SBUH officials said, adding that exceptions will be made in pediatrics, labor and delivery, maternity and neonatal intensive care, also end of life on a case-by-case basis.

Catholic Health Services of LI: St. Charles and St. Catherine hospitals

Catholic Health Services of Long Island, until further notice, has suspended visits to all its hospitals as well as skilled nursing facilities, according to its website. Hospital officials said exceptions will be made on a case-by-case basis, which will entail hospital and nursing home leadership making a decision in conjunction with its infection prevention department and following Centers for Disease Control and Prevention guidelines for screening for the coronavirus before allowing visitation. CHS may make exceptions for end of life and newborn delivery.

On the CHS website, Dr. Patrick O’Shaughnessy, executive vice president and chief clinical officer, explained the screening on the system’s website.

“At all CHS hospitals emergency departments, in our skilled nursing facilities and throughout our regional nursing service, we are actively screening, asking patients about recent travel and looking for signs and symptoms of the virus,” O’Shaughnessy said. “Symptoms include fever and respiratory issues. Also, we are taking these precautionary steps at our owned physician practices.”

CHS has canceled all elective surgeries from March 23 through April 24, according to its website.

Northwell Health: Mather and Huntington hospitals

Northwell Health Labs announced March 11 in a press release that it began semi-automated testing for COVID-19 through its Lake Success facility.

“Since we began manual testing Sunday evening, we processed about 133 tests,” said Dr. Dwayne Breining, executive director, in the press release. “Moving to this semi-automated system will enable us to increase our testing capacity immediately to about 160 a day, and then to several hundred a day later this week.”

Dr. John D’Angelo, senior vice president and executive director of Northwell Health’s emergency medicine service line, said in an email that changes have been in place for a while in its health care system.

John T. Mather Memorial Hospital in Port Jefferson is sending tests to Northwell’s Lake Success facility. File photo from Mather Hospital

“We instituted changes from normal practice long ago, starting with 100 percent screening of all patients on arrival with positive screens being masked immediately and escorted directly to a private room for further investigation,” D’Angelo said.

He added that a decision was made soon after to mask every employee after emergency department changes.

“I believe we were the first in the region to institute such a mask mandate,” he said. “Lastly, as traditional screening (travel to CDC level 2/3 countries or known close contact) became less relevant, we decided to mask everyone — all patients, all visitors and all staff — while we continue to aggressively cohort patients with potential COVID-like symptoms.”

Emergency department volumes in the Northwell system have remained at or below average, according to hospital officials.

“The public is listening and staying home,” said Dr. Leonardo Huertas, chair of emergency medicine at Huntington Hospital.

D’Angelo said a surge plan is in place for all Northwell system emergency departments which can be used if the overall general volumes increase “or if there is a surge of COVID-suspected patients.”

He added that if a plan was needed “an exterior ‘split-flow’ model” would be put in place. This would enable those who may possibly have COVID-19 but aren’t that sick to be treated in an alternative care site adjacent to the emergency room, while “those arriving with COVID symptoms but are too sick for the alternative care site will be brought directly into a predetermined, cohort isolation area within the emergency department. Every site has such plans.”

Northwell has also canceled all elective surgeries. These surgeries, endoscopies and other invasive procedures in the outpatient setting will continue when doctors determine that they are clinically necessary.

A Mather Hospital official also said that the junior and adult volunteer programs have been suspended, and the hospital is working with Northwell on childcare alternatives for staff members.

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Huntington Hospital and Northwell released slides displaying the purpose of social distancing and other measures to "flatten the curve." Image from Northwell

As testing for the coronavirus COVID-19 increases in Suffolk County and throughout the country, so too does the number of confirmed cases. As of Wednesday, Suffolk County had 152 confirmed cases, with three fatalities.

“We were behind the eight ball on testing for a while now,” County Executive Steve Bellone (D) said on a conference call with other members of the National Association of Counties and the press. “Those numbers are going to continue to jump. All of these efforts about trying to contain that.”

There are 17 positive tests in Brookhaven, 43 in Huntington, 23 in Islip, and 3 in Smithtown. People who would like to get tested can call 888 364 3065. Residents won’t automatically receive a test if they show up. They need to go to a doctor or have a telephone reference for a possible test. Bellone expects the requirements for testing to loosen up in the coming days.

To protect police officers, Bellone urged residents to file some reports online. Residents can file lost property, criminal mischief, non-criminal property damage, and minor motor vehicle damage, among other issues, through the web site https://www.suffolkpd.org.

The county executive also reminded residents who are experiencing a mental health emergency can reach out to the Dash Center in Hauppauge, which is the first crisis stabilization center on Long Island.

This week, Bellone’s office continued to take numerous steps to inform the public and protect first responders. He encouraged residents to sign up for Smart911, to provide emergency responders with critical medical information. Residents can sign up through the website www.smart911.com.

Residents can also sign up for text message updates on their mobile devices if they text CovidSuffolk to 67283. Over 10,000 people signed up for the texting service on the first day, the county executive said.

Apart from ongoing concerns about the spread of the virus, residents are confronting an economy that has ground to a halt, as people maintain social distancing and businesses from movie theaters to bowling alleys to dry cleaners all closed.

The government “knows the impact to businesses will be devastating,” Bellone said on the call.

The county executive has put together a business response plan and is working to collect data from local businesses. He also advised he continues to work with a business response team, which the Department of Economic Development and Planning and the Suffolk County Department of Labor are leading.

Bellone said the business group was in the “discovery phase” of the plan, as the Department of Labor takes the lead on collecting data from businesses to find out “what’s happening on the ground with their work force.”

He encouraged businesses to reach out through 311 to provide information about the impacts of the virus.

Bellone said he was working on supply chain issues for personal protection equipment for health care workers. He is also hopeful that Gov. Andrew Cuomo (D) will find ways to work with the Army Corps of Engineers to expand hospital bed capacity to meet the anticipated surge in demand. 

As of now, Suffolk County has 2,300 hospital beds, of which 391 are currently available. There are 242 Intensive Care Unit beds, of which 68 are available.

George Latimer, the Westchester County executive, also shared his experiences and his expectations for the progression of the virus on the National Association of Counties call.

Westchester’s cases, which surged to 308, said the county is “where many places will be,” with its number of infections and its efforts to contain the spread of the virus.

Latimer wasn’t optimistic about the potential to reopen schools in his county any time soon.

“I doubt we’ll see academic [efforts] back before the end of June,” Latimer said. “That will cause all sorts of disruptions.”

Latimer said he is concerned about beds and ventilators and that his district has asked retired nurses and doctors if they would return to service.

County executives from other areas also expressed concerns about numerous other challenges, including helping the homeless population, safeguarding people in prisons, protecting first responders and health care workers, and managing their counties’ finances while tax revenue plummets and costs skyrocket.

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Image from CDC

Just a week after Suffolk County had no confirmed cases of the coronavirus Covid-19, the number of positive tests continues to climb. As of Tuesday, the county had 97 positive tests, with 13 in Brookhaven, 24 in Huntington, 11 in Islip and three in Smithtown.

None of the people who tested positive in the county to date is below the age of 18.

At the same time, the number of deaths attributable to the pandemic stood at three, as a woman in her 90s who was at Huntington Hospital died after contracting the virus.

Suffolk County Executive Steve Bellone (D) extended his condolences to the families of those who lost a loved one to the virus.

The County has tested 564 people, with 17 percent testing positive so far.

On a media briefing conference call, Bellone said the “idea that there are individuals that are traveling and bringing the virus here” is no longer relevant. People in the county came down with the virus through community transmission, which is why the county is joining so many other areas of the country in continuing to encourage social distancing while restricting access to sites where people might otherwise congregate, particularly on a day like St. Patrick’s Day. Bars and restaurants will only offer take-out and delivery.

At the same time, the county has closed the Civil Service Office. People can submit test applications online.

Suffolk County has accepted financial aid from the state, specifically $700,000 from the New York State Department of Health. These funds will support the local health department and “critical work on the front lines,” Bellone said.

Additionally, Suffolk County is transferring $500,000 from the Department of Public Works’s Snow Removal Fund to support the Department of Fire, Rescue and Emergency Services. This will support emergency responses efforts underway and will help purchase additional protective equipment.

“We caught a break with snow removal,” Bellone said. “We had very little snow this year.”

Bellone said he continues to work with a business response team, which the Department of Economic Development and Planning and the Suffolk County Department of Labor are leading.

Bellone said the business group was in the “discovery phase” of the plan, as the Department of Labor takes the lead on collecting data from businesses to find out “what’s happening on the ground with their work force.”

Bellone encouraged residents to sign up for Smart911, to provide emergency responders with critical medical information. Residents can sign up through the web site smart911.com. Residents can also sign up for text message updates on their mobile devices if they text CovidSuffolk to 67283.

Suffolk County hopes to have a mobile testing site up and running later this week. Suffolk County residents can make an appointment for a test by calling 888-364-3065. A triage nurse or health care professional will determine if people need tests.

It generally takes two to three days to get the results of the tests.

Separately, starting on Thursday, Stop & Shop will allow seniors who are over 60 years old to shop at their stores from 6 am to 7:30 am. The delis will open at 7 am.

Meanwhile, Brookhaven National Laboratory has suspended site access for all users, visitors and guests starting today, March 17th. The only exceptions are for users who are already on site and for users and guests permanently based at the laboratory. Facilities including the Relativistic Heavy Ion Collider, the National Synchrotron Lightsource II and the Center for Functional Nanomaterials will continue to operate.

BNL has also canceled all of their Educational and Science Learning Center programs through April 17th. The Department of Energy lab will review the program at that point. BNL has also canceled all open-to-the-public events and smaller group public tours for the next 30 days.

The lab is reviewing meetings of more than 30 people over the next month and will decide which to cancel.

BNL is encouraging telework for those people whose job responsibilities allow them to do so. The lab also has a pandemic plan that specifies essential positions and a minimum number of essential employees if they have to go to a reduced level of operations.

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A blood sample with respiratory coronavirus positive. Stock photo

Suffolk County has recorded its first two deaths from the coronavirus Covid-19, while the number of positive tests continues to climb and was at 74 as of early Monday.

Peter Scully, left, was confirmed to have contracted coronavirus. The county executives office has limited contact with others. File photo

A man in his 80s, who had been in isolation at St. Catherine’s Hospital in Smithtown, passed away, according to county officials. Another man, who was in his 90s and was in isolation at Huntington Hospital, also succumbed to the virus that has caused a pandemic throughout the world.

“It’s with great sadness” that Suffolk County Executive Steve Bellone (D) reported that the virus has taken the lives of the two people. “We offer our condolences and sympathies to the family who have lost loved ones and we will do everything we can to contain the spread of the virus,” he said on a conference call with reporters Monday, March 16.

One of the confirmed positive cases includes a member of Bellone’s senior staff, Peter Scully, a Deputy Suffolk County executive. While Scully is “doing well,” he remains at home in isolation, where he continues to work as part of the team responding to the virus that has given him a sore throat and chills, according to Bellone.

Several members of Bellone’s team are under mandatory quarantine because they have had direct contact with Scully, which includes spending more than 10 minutes within six feet of him. That list includes Gregson Pigott, who is the commissioner of the county’s Department of Health Services.

Although he was not in direct contact with Scully, Bellone has been directing the response to the virus from his home office.

“The guidance we put out is important for everyone to follow, including top levels of the government,” Bellone said. “Leadership by example is important and it is important for people to know you can follow this guidance but continue to do the things you need to do.”

Bellone expressed some concerns about children gathering to spend time together, particularly with the approach of the warmer spring weather.

“We want to send a message out to parents and the community that it is important that while kids are home, it’s not a time for mass gathering,” Bellone said. “Parents need to be following social distancing guidelines for kids.”

Indeed, school children in Nassau and Suffolk County have been out of school starting Monday for at least two weeks.

Northwell Health, meanwhile, announced that it is postponing elective surgeries. The new guidelines don’t apply to emergency surgeries. Elective surgeries, endoscopies and other invasive procedures in the outpatient setting will continue when doctors determine that they are clinically necessary. If the medical staff decides these surgeries are not essential, they will be postponed or cancel them to minimize exposure to Covid-19 for patients and staff. Northwell is also asking its practitioners to reschedule non-essential visits unless medical necessary within the next four weeks. Planned imaging procedures including Magnetic Resonance Imaging, or MRIs, Computed Tomography (CTs) and ultrasound will not be canceled. Patients confirmed for imaging will be contacted prior to their visits to identify those people who might be at higher risk from the virus.

Comptroller John Kennedy is preparing for the possibility of closing the Hauppauge and Riverhead offices. The Comptroller indicated that he may need to close these offices or restrict the work from home. Even if that occurs, however, the Comptroller has worked with financial institutions to ensure that the government continues to function and funds remain available. Kennedy ensured that PayMySuffolkTaxes.com has been working for almost a year, which will allow residents to pay delinquent property taxes online. He also launched a self-service tool, SuffolkSelfService.com to allow vendors to make status payments and notify appropriate personnel.

Governor Andrew Cuomo (D) urged residents to report any price gouging for products such as hand sanitizers or household cleaning supplies. The phone number to call is 1-800-697-1220.

Suffolk Parks remain open and are operating on normal business hours. Organized events and youth group camping, however, have been suspended. Residents can call 311 to confirm if an event is still taking place.

Sheriff Errol Toulon, Jr. has suspended all visits with inmates at Suffolk County Correctional Facilities starting on March 17th. Attorneys may continue to see their clients. While there are no current cases of the virus at the facilities, Toulon indicated he made this decision to control the spread of the illness. Toulon also suggested that most office bureaus are available by phone or website and urged people who do not need to visit the office to make contact from home.

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An empty toilet paper display case at the St. James King Kullen March 14. Photo by Joseph Cali

With shelves emptying quicker than they can replenish, as shoppers afraid of possible COVID-19 quarantines stock up, grocery store chains are trying to come up with answers. 

In a press release, King Kullen announced starting Monday, March 16, all its stores, including its pharmacies and Wild by Nature locations will open at 8 a.m. and close at 8 p.m.

The chain said the new hours of operation were until further notice, and the change would allow them “to better serve its customers, provide relief to employees, give store teams time to conduct additional preventative sanitation, and allow more efficient restocking of product on shelves.”

Stop & Shop starting Thursday, March 19, will allow those who are over 60 years old to buy groceries at their stores from 6 to 7:30 a.m., according to a March 16 press release.

“Although we will not be requesting ID for entry, we ask that you please respect the purpose of the early opening — and do the right thing for your neighbors,” the statement read. “Store associates do reserve the right to ask customers to leave if they are not a member of this age group.”

Stop & Shop also announced most stores have adjusted their hours to 7:30 a.m. to 8:00 p.m. which will help with unloading deliveries and stocking shelves.

The chain also announced that its Peapod home delivery service will have a contact-free option where bags can be left on a doorstep or entryway.

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Centereach High School

Suffolk County schools closed for two weeks starting Monday, March 16, in response to concerns regarding the coronavirus pandemic.

After recommendation of the Suffolk County Health Commissioner and consulting with the Suffolk County School Superintendents Association, County Executive Steve Bellone (D) March 15 issued a Local Emergency Order to close all schools in the Suffolk for two weeks.

In a statement, Bellone said discussions with state officials and the Superintendents Association included issues involving student meal programs and childcare.

“There is evidence that the virus is already present in many communities we serve, and our efforts now must be aimed at preventing its spread,”  Bellone said in a statement. “As part of our larger social distancing efforts, we believe that closing schools is the right thing to do at this time.”

Bellone said the county asks parents to encourage children to practice social distancing and hand washing frequently to help to contain the coronavirus. The county also suggests that anyone who is symptomatic to stay home and quarantine themselves as a precautionary measure.

Administrators and teachers will have access to school buildings during the closures. This will enable them to conduct district planning, distance-based learning, set up temporary grab-and-go meals and address childcare issues.

 

 

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