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Concerns for monkeypox and COVID-19 build for the fall

by Daniel Dunaief - August 4, 2022

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The reported rate of positive tests for COVID-19 is likely well below the actual infection rate, particularly for the highly-transmissible BA.5 strain of Omicron, health care officials said.

“I expect that we’re at least double, and we’re probably significantly higher than double,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “I, like many others, am quite concerned for the fall and winter.”

Indeed, with positive results for PCR tests in the range of 10 to 12% during the summer, the percentage of people who might contract the most infectious variant of the virus yet could surge in the colder months, when students return to school and people spend more time indoors.

The good news so far is that the number of people who have been hospitalized with COVID has stayed relatively steady at Stony Brook University Hospital, at around 50.

Over the past few weeks, the number hasn’t dipped below 40 or gone above 75, which means that the current infections generally aren’t causing hospitalizations, Nachman said.

“While COVID-19 rates may be higher than reported, cases are less severe than they were at earlier stages of the pandemic and hospitalizations are fewer,” Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Service, explained in an email. “Vaccinations play a large role in the reduction of hospitalizations.”

The number of people hospitalized with COVID on Long Island averages about 450 per day, which is down from 4,000 in April of 2020 and 2,200 in January of 2022, according to the county Department of Health.

Suffolk County hosted a back to school test kit distribution event on Tuesday at the H. Lee Dennison Building for parents and residents.

Raising awareness of monkeypox

At the same time, government and health care officials are dedicating more resources to combat the threat from monkeypox, a virus with symptoms including fever, headaches, exhaustion and a rash that can last two to four weeks.

In Suffolk County, the number of confirmed cases has climbed to 22 as of the beginning of August, according to Department of Health officials.

Working with Northwell Health and Stony Brook University, the county has been providing monkeypox vaccinations. The county expects to get more vaccines later this month, although the demand continues to exceed the supply.

Governor Kathy Hochul (D) declared a state of emergency on July 29 over the outbreak, which will allow a faster response and enhance the distribution of vaccines in the state. The governors of California and Illinois have also declared states of emergency over a virus that is rarely fatal but is painful and can cause scarring. The more vulnerable populations include pregnant women, young children, people who are immunocompromised and individuals who have a history of eczema.

Nachman said the response from the governor was a “way of getting ahead” of the spread of the virus.

The state of emergency “raises everyone’s concern,” Nachman said. “When you go to a local physician, more people are thinking, looking and testing [for monkeypox]. Testing is critical” to confirm cases and to reduce the spread.

Vaccinations, which involve getting two shots that are four weeks apart, can accelerate the immune response, Nachman said.

Stony Brook hopes in the next few weeks to work on a National Institutes of Health-funded clinical trial with children, pregnant and postpartum women on a potential treatment for the virus.

Spread during physical contact, the large majority of monkeypox cases have occurred among men who have been intimate with other men.

Pigott has been working closely with the community to promote prevention efforts and vaccinations. He spoke on Monday at a forum hosted by the LGBT Network, where he said gay or bisexual men in their 20s and 30s were at the highest risk.

Other viruses

In addition to COVID concerns for the fall, Nachman explained that other seasonal respiratory viruses have become more prevalent and problematic through the summer.

Flu has historically been a winter virus, starting in late November or early December and ebbing in its infectiousness around March.

In 2022, the flu season stretched through June. At the same time, respiratory syncytial virus, or RSV, typically starts in November and lasts through February.

“We had RSV all summer long,” Nachman said. “We never had a break.”

Nachman is concerned that the overlap among the viruses with infection rates may increase at the same time.

“I worry about the juxtaposition with other respiratory pathogens” that have exceeded their usual seasonal limitations, Nachman added.

Those other viruses are highly contagious, but were limited in their spread when people were wearing masks. Once people stopped taking precautions for COVID, these other viruses also spread.

“No one had been exposed, and it was like a match to tinder,” Nachman said. “It spread through the population” after few people had contracted these illnesses.

Health care providers urged people to take several steps to protect themselves, their families, and their communities.

“If you’re sick, please don’t go to work,” Nachman said. ‘If your child is sick, please don’t send them to school.”

People also need to practice safe cough techniques. If they need to cough or sneeze, they should minimize the number of aerosolized particles by covering their nose and mouth or coughing into their clothing.

A plea for proper vaccinations

With a reluctance to return to the widespread use of masks or other restrictions that might limit the spread of COVID, health care officials continue to urge people to benefit from the protection vaccines provide.

Indeed, most of the people who have required more extensive medical care at Stony Brook University Hospital have not been fully vaccinated.

Some of those who have required medical attention received a single dose of a vaccine over two years ago, which is effectively not vaccinated, she said.

Nachman expects that COVID vaccinations may become required as they are for measles mumps and rubella and other diseases for students to attend class in person.

“I do see in the future that will happen,” Nachman said. “Not vaccinating hurts the child and the entire community.”

COVID-19 infections increasing, concerns climb about the fall

by Daniel Dunaief - May 10, 2022

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mask-g211d306f3_1920 — Doctors recommend mask-wearing during indoor gatherings. Stock photo from Pixabay

In Suffolk County, the number of positive COVID-19 tests has been steadily climbing in the last month, mirroring the increase in other counties in the state and in parts of the country.

As of May 9, the number of people who tested positive per 100,000 residents on a seven-day average was 47.8. That is up from 34.9 a week earlier, 13.4 on April 9 and 6.3 on March 8, just over two months earlier, according to data from the New York State Department of Health.

“The numbers are creeping up,” said Dr. Mickel Khlat, chief medical officer at St. Catherine of Siena Hospital in Smithtown. Catholic Health had about 28 to 30 patients a month ago with COVID-19 and that number has now risen to the mid-60s. Most of those are incidental, he added, as the hospital discovered a positive test when a patient came in for another procedure. These positive tests, however, reveal the ongoing presence of the virus in the community. “I was hoping in 2022 that this would go away, but I don’t see this going away any time soon.”

Area doctors and health officials suggested familiar practices to reduce risks, including social distancing and mask-wearing in confined spaces indoors and ensuring up-to-date vaccinations.

“Immunity from vaccines and immunity from infection with SARS-CoV-2 virus wanes, so we urge everyone to get vaccinated and to get their booster or second booster if you are eligible,” Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Service, explained in an email.

Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that the hospital is recommending that people speak to their primary care providers to get the best advice on their need to get a second booster.

“Often, individuals may not realize that they fall into a category of vulnerable populations,” she explained in an email. “These can include not only adults with immune issues, but also those with heart and lung diseases, kidney issues, obese individuals and, of course, those who are elderly.”

Khlat said since the virus first reached Suffolk County, obesity is often the underlying condition that presents the greatest risk factor for dying, which was evident in the first and second surges.

People of all ages in Suffolk County have been hospitalized, even children, Pigott added.

Recently, fewer sick people have needed medical attention in the intensive care unit.

The majority of people who are under 65 years old and in the ICU are unvaccinated, Pigott added.

In general, the most common symptoms for COVID-19 include respiratory issues as well as fever, Nachman said. Other symptoms include gastrointestinal issues.

“If you have symptoms, please consider doing a rapid test to evaluate the possibility” of having the virus, Nachman added.

The coming fall and winter

In the broader context, state and national officials are anticipating a challenging fall and winter. Earlier this week, the White House estimated that the country could experience as many as 100 million new infections without renewed mitigation measures.

While daunting, particularly in the third year of the pandemic, the large number of potential new infections could encourage Congress to appropriate more funds to combat the virus and alert state officials to the need for measures to protect residents.

Area hospitals have already started to consider the possibility of a rise in infections later this year.

“We are anticipating increase in illness this upcoming fall and winter and are addressing those needs now” through supply chain preparations and other measures, explained Nachman.

Khlat said St. Catherine continues to make sure the hospital has enough personal protective equipment, including N95 masks. While he suspects the tighter quarters in colder weather could contribute to a surge, he doesn’t expect people will be as sick this time.

If they do get sick, patients can receive the first and second dose of remdesivir in the hospital and then get their next few doses at home, through a hospital-at-home program.

Medical options

Pigott urged those who are at risk and test positive to contact their medical providers soon after testing positive and/or developing symptoms.

Those who contract COVID-19 have several therapeutic options, especially if they have mild-to-moderate symptoms and are at risk for severe disease.

“COVID-19 antiviral medications or therapies should be started within five to seven days of symptom onset,” Pigott explained.

Nachman added that treatments for Covid include monoclonal antibodies and Paxlovid.

“They can be difficult to get, difficult to take and, particularly for Paxlovid, have serious drug-drug interactions,” Nachman cautioned. “They are indicated for those with underlying medical issues. Other therapies, although less commonly available, include intravenous remdesivir.”

Khlat said he’d recently heard of two cases in which patients took a five-day course of Paxlovid.

“A week or two later, they came back for monoclonal antibodies,” he said. People had “relapsed from Paxlovid. That, I never heard of before.”

Generally, Khlat said Paxlovid works well, although he, too, cautioned about drug interactions.

With fewer and shorter hospital stays for people who contract COVID-19, hospitals continue to have capacity. “We are not seeing an influx of patients getting admitted for COVID,” Khlat said.

Long Island Museum highlights Brookhaven National Lab with Atoms to Cosmos exhibit

by Melissa Arnold - April 21, 2022

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D2770119 — Milinda Abeykoon, lead beamline scientist at Pair Distribution Function Beamline, NSLS-II, aligning a sample holder for high-speed measurements, 2019. Photo courtesy of BNL

By Melissa Arnold

Over the past 75 years, Brookhaven National Lab (BNL) in Upton has become an international hub for innovative research and problem-solving. Their hard work has led to advancements in energy, medicine, physics and more, as well as seven Nobel Prizes.

A scientist at a fast neutron chopper at the Brookhaven Graphite Research Reactor (BGRR), 1953. Photo courtesy of BNL

This year, the Long Island Museum in Stony Brook will celebrate the lab’s myriad achievements and explore their deep roots in the area. The new exhibit, titled Atoms to Cosmos: The Story of Brookhaven National Laboratory, opens April 21.

BNL and the Long Island Museum started working on ideas for a future exhibition back in 2018 with plans to open in April of 2020. But as with other museums, the pandemic led to a halt in operations.

In some ways, the rescheduled timing of the exhibit is better than their initial plans.

“While the exhibition was temporarily shelved, both the lab and the museum wanted very much to still make it happen. We had done so much work in advance and preparation for it in 2020, and so we really wanted to get back to this opportunity,” said Joshua Ruff, Deputy Director and Director of Collections and Interpretation for the Long Island Museum. “We are especially pleased we were able to do it now, as it fits nicely with the lab’s 75th anniversary celebration.”

Brookhaven National Laboratory was founded in 1947 at the former site of the U.S. Army’s Camp Upton, becoming the first large research facility in the Northeast. At the time, they were exploring peaceful ways to utilize atomic energy.

“The BNL site has been in federal ownership since 1917 when it became the location of Camp Upton. Before that, the site was used for the cordwood industry and there was a small farm near the eastern edge of what is now the lab,” explained Timothy Green, BNL’s Environmental Compliance Section manager. “After World War I, all of the buildings were sold at auction and the site sat empty until around 1934, when it was declared the Upton National Forest and the Civilian Conservation Corps started planting trees. At the end of World War II [and a second period as Camp Upton], the land was transferred to the Atomic Energy Commission and became Brookhaven National Laboratory.”

It took some time for local residents to adjust to having a laboratory in the area, Ruff said.

A Positron Emission Tomography Halo Scanner/Detector.
Photo courtesy of BNL

“The lab has often been misunderstood in its past, in fact from its origins. Many Suffolk County residents were not entirely sure that atomic research was safe, nor did they fully understand the relevance and significance [of that research] to their lives,” he explained. “The lab devoted years of hard work and financial resources to strengthen public dialogue and communication, which the exhibition details.”

Today, the lab employs almost 3,000 people and spans 5,320 acres.

The exhibit is co-curated by Joshua Ruff and Long Island Museum curator Jonathan Olly. They’ve included more than 140 items that showcase the lab’s growth and varied discoveries from the 1950s to the present day. The Smithsonian Museum of American History in Washington is lending four of the objects, including a 1,000-pound, 94-inch square magnet lamina from the Cosmotron, BNL’s first major particle accelerator.

Another 40 objects are coming directly from the lab. Their contribution includes equipment from their facilities, personal belongings of former director Maurice Goldhaber, and “Atoms for Peace,” a famous painting that came to symbolize the lab’s work in its early years.

“A lot of the scientific research at BNL over the years has involved [developing] and testing cutting edge technologies. When these machines are no longer useful they’re usually recycled. Fortunately we do have two examples in the exhibition of early PET (Positron Emission Tomography) scanners, one from 1961 and another from 1981,” Olly said. “In the case of these early machines, the focus was on the brain — the machines used radiation sensors arranged in a ring to produce a picture of a slice of your brain. Brookhaven scientists have used this PET technology (specifically the PETT VI scanner in the exhibition) in studying drug and alcohol addiction, eating disorders, ADHD, aging, and neurodegenerative disorders. The 1961 version is a prototype that was never used on patients.”

Also on view are an original chalkboard from the Graphite Research Reactor that still has writing on it; a 7-foot window from a bubble chamber that helped track the paths of atomic particles; and a detector that aided BNL chemist Raymond Davis Jr. in his Nobel Prize-winning neutrino research.

Recently, the lab was a part of the ongoing effort to study and contain COVID-19. The exhibit will include a model of the virus, with the familiar spiky shape that’s become commonplace since the pandemic began.

“Scientists at the lab’s National Synchrotron Light Source II worked on imaging the virus and the proteins … that allowed it to attach to human cells. At the same time, BNL computer scientists began developing algorithms to evaluate existing chemicals and drugs that could potentially prevent infection. One past experiment by [BNL biophysicist] William Studier, the T7 expression system, ended up being critical to the rapid development of two of the vaccines,” Green said.

Both the Long Island Museum and BNL staff hope that visitors to the exhibit come away with a deeper interest in science and an appreciation for the lab’s work.

“There are 17 national laboratories scattered throughout the United States, and Long Islanders can be proud to have one in their backyard. Long Island children have been inspired to pursue careers in science as a result of attending educational programs at the lab during public visitor days dating back to the 1950s. And the lab is invested in addressing our real-world problems, whether the dangers posed by DDT on Long Island in the 1960s or COVID now. This summer BNL should be resuming their “Summer Sundays” visitor program, and I encourage everyone to visit the lab, walk around, talk to staff, and get a glimpse of our scientific present and future,” Olly said.

Atoms to Cosmos: The Story of Brookhaven National Lab is on view now through Oct. 16 in the Long Island Museum’s History Museum and Visitor Center’s Main Gallery, 1200 Rt. 25A, Stony Brook. Regular museum hours are Thursday through Sunday from noon to 5 p.m. Masks are required at this time, though health and safety guidelines are subject to change Admission is $10 for adults, $7 for seniors, and $5 for students 6 to 17 and college students with I.D. Children under six are admitted for free. Tickets are available at the door; pre-registration is not required. For more information visit longislandmuseum.org or call 631-751-0066.

Learn more about Brookhaven National Lab at www.BNL.gov.

Even amid slightly higher COVID numbers, local doctors endorse return to normal life

by Daniel Dunaief - April 8, 2022

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Movie-Theater-Pixabay — Many doctors are suggesting people learn to live with the virus and begin returning to usual activities such as going to the movies. Photo from Pixabay

Dr. Gregson Pigott went to the movies this week.

While the activity would be considered mundane in 2019, the decision to go to the theater to catch a flick is yet another example of how local doctors, or, in this case, commissioner of the Suffolk County Department of Health Services, is practicing what he preaches.

“We need to learn to live with the virus,” said Pigott, who has also been to a few Brooklyn Nets basketball games. Pigott, who is not using a mask except in situations where it is required, such as on a plane or on public transit, suggested people are “trying to resume life as it was pre-COVID.”

While the percentage of positive tests has risen, the numbers haven’t raised any alarm bells.

The percentage of COVID positive tests increased to a seven-day average of 2.6% as of April 2, according to figures from the New York State Department of Health.

That figure is higher than it had been in the weeks prior, when the percentage dipped below 2%.

“I certainly expected this,” Dr. Sean Clousten, associate professor of Public Health at Stony Brook University explained in an email. “I suspect this increase is due to unmasking at public schools because many kids who are infected are asymptomatic or the symptoms are different.”

Pigott said the current symptoms for the newer variant of omicron, called BA.2, which is becoming the dominant strain across the country and through much of the world, includes stuffy noses, scratchy throat and a slight cough.

Clousten added that the symptoms can also appear more like a bad stomach bug.

Second booster

Recently, the Food and Drug Administration approved a second booster for people over 50 and for those who are immunocompromised and who had a first booster more than four months ago.

Pigott said he would urge people who are over 65 or those who are immunocompromised to consider getting another jab.

“Most of the general population is fine with the three-shot regimen,” Pigott said. “Your body will recognize any kind of COVID infection and deal with it quickly.”

Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, indicated in an email that Stony Brook has been “advocating for switching vaccines.”

Switching vaccines could mean triggering a different response to the shot for the second booster, Nachman added.

Data about a second booster shows that the shot provides “good protection” against serious COVID, Nachman said. “Will it protect against any infection (meaning you might get a runny nose, cough or upper respiratory infection)? Not really.”

Nachman urged people to consult with their primary care doctor to decide whether to take a booster. What people are doing and where they are going can and should affect that decision.

Finally, daily activities such as going back to a crowded office or starting to take New York City transit could be “excellent reasons” to get a booster, she said.

Nachman plans to get a booster, although she is working on the best timing for another shot.

“Before I travel abroad is key to making sure I have my booster and am protected,” Nachman added.

Conferences

Nachman is encouraged that people are returning to in-person conferences and other activities.

“It will be great to have people starting to get back to routine living, and that means being with other people,” she explained in an email.

She urged people to stay at home if they don’t feel well.

“Now is not the time to push to go to that meeting or get together with extended family, since you might just be responsible for getting someone else sick,” she explained.

She suggested people should be patient and understanding of others who choose to wear masks or continue to practice social distancing.

“Don’t shame anyone who is wearing a mask,” Nachman advised. “If that is what it takes to get them together with you in public, go for it.”

In another sign of a return to a pre-pandemic life, Pigott suggested that the Health Department was planning to direct more resources to tracking illnesses like Lyme disease.

Amid declining COVID infections, worry about mental health remains

by Daniel Dunaief - February 24, 2022

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The percentage of positive COVID-19 tests in Suffolk County continues to plummet, raising expectations of more mask-optional or mask-free options for businesses and public places in the weeks and months ahead.

The percentage of positive tests, which the Omicron wave caused to crest in the mid to high twenties in the first few weeks after the start of the year, continues to plunge into the low single digits.

Indeed, as of Feb. 20, the seven-day average for positive tests was down to 2.2%, which is considerably lower than the mid to high 20% tests in the first few weeks of January, according to public information from the New York State Department of Health.

“The data are very promising and supportive of the idea that masks may not be necessary in social settings,” Sean Clouston, associate professor in the Program in Public Health and the Department of Family, Population and Preventive Medicine at the Renaissance School of Medicine at Stony Brook University, explained in an email.

A spring and summer that lifted some pandemic rules would relieve the strain of a public health threat that claimed the lives of community members, shut down businesses, altered school learning environments and created a mental health strain.

Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services, explained that the decline in positive tests was “expected” and that it was “reassuring that the predictions held.”

The Health Service Commissioner is hoping, unless new, more virulent variants develop that “we will enter into a period of respite from COVID-19.

Pigott, however, added that Suffolk County hospitals still had COVID patients. People over 65 have seen the greatest decrease in hospitalizations. The senior age group had accounted for 65 to 70% of hospitalizations last January.

That rate has steadily declined amid a high rate of vaccinations and boosters.

The most recent surge caused by the Omicron variant has elevated the levels of hospitalizations among younger age groups, especially for those who are not vaccinated, Pigott explained.

On the positive side, hospital stays have likely generally been shorter than in the earlier days of the pandemic as the “medical profession has learned over the course of time what interventions work best,” Pigott added.

Monoclonal antibodies and antiviral medications such as remdesivir have reduced the likelihood of significant illness when people with positive tests receive these treatments soon after diagnosis, Pigott explained.

As for boosters, Pigott didn’t anticipate the broad need for additional shots in the immediate future.

“Recent studies are showing the booster shot to hold up quite well over time, so perhaps a booster will not be needed, at least not for a while,” he wrote.

Although doctors have identified a new subvariant of Omicron called BA.2 that the county is monitoring carefully, the World Health Organization has not classified it as a variant of concern.

Mental health

Even as the physical threat from COVID-19 may be receding, health care professionals suggested that the mental health toll from the pandemic may require continued monitoring and support.

Pigott cited two new CDC studies that indicated the children’s mental health crisis has gotten worse during the pandemic.

Adam Gonzalez, associate professor of Psychiatry & Behavioral Health at the Renaissance School of Medicine at Stony Brook University, explained that young adults, in particular, have been struggling with increased rates of anxiety and depression.

According to the Center for Disease Control and Prevention’s Household Pulse Survey, which is a 20-minute online survey, 39.2% of people nationally aged 18 to 29 had indicators of anxiety or depression between Jan. 26 and Feb. 7 of this year.

The group with the lowest percentage of such indicators was 80 years and above, with 9.3% of that age experiencing these indicators.

“The elevated rates of mental health problems highlight the need for mental health screening, referral and treatment — incorporating mental health as part of one’s overall health and well-being,” Gonzalez added.

Stony Brook Medicine is screening for depression throughout its practices to identify people who need mental health care support, Gonzalez wrote.

Cognitive behavioral therapy in particular is effective in helping improve mental health, with a group format proving just as effective as individual therapy, Gonzalez explained.

Gonzalez added that even a single session can help improve mental health, putting people back on a healthier path.

Gonzalez has been partnering with Jessica Schleider, assistant professor in Clinical Psychology at Stony Brook University, to teach people “how to break down problems into manageable steps. Our overall goal is to help get people the skills they need to effectively manage their mental health.”

Suffolk County’s positive COVID-19 tests continue to decline

by Daniel Dunaief - February 10, 2022

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Over the last month, the pandemic trends continue to improve in Suffolk County and in the country.

After a rocky start to the New Year, brought on by an omicron variant that was more contagious than either the original strain of the virus or the delta variant, the percentage of positive tests in Suffolk County continues to decline.

As of Feb. 7, the percentage of positive tests over a seven-day average in Suffolk County was 4.9%, according to the New York State Department of Health. That is down from 14% on Jan. 21 and 27% on Jan. 7.

The trends on Long Island are following similar patterns in other parts of the world that experienced the omicron infection earlier.

South Africa “experienced the omicron wave first,” Dr. Gregson Pigott, health commissioner of the Suffolk County Department of Health Services, wrote in an email. “Almost as steeply as cases rose, they fell.”

Indeed, at Port Jefferson’s St. Charles Hospital, Dr. Sunil Dhuper, chief medical officer, said there has been a “significant” drop in the number of patients hospitalized and in the number of Emergency Room visits, while the use of monoclonal antibodies to treat patients in the early stages of an infection has also dropped dramatically.

“We are not seeing the kind of volume we were seeing a few weeks ago,” Dhuper added.

The Department of Health for the country reported that the reinfection rate, which reached a peak in the last week of December and first week of January, has also been declining.

The number of hospitalizations throughout the country has fallen enough that Dr. Anthony Fauci, the chief medical adviser to President Joseph Biden (D), recently said in an interview with the Financial Times that the country is almost past the “full-blown” pandemic phase. While he didn’t offer a specific timetable, he suggested that virus restrictions could be lifted within a matter of months.

Area doctors suggested that vaccinations and more mild symptoms among those who contracted the virus helped alleviate the strain on the health care community.

“The vast majority of those hospitalized for respiratory or other COVID-type illnesses have not been vaccinated,” Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, explained in an email.

While the overall number continues to decline, the county, and the country, need to make continued progress in reducing the overall infection rate before the all-clear signal.

Sean Clouston, associate professor in the Program in Public Health and the Department of Family, Population and Preventive Medicine at the Renaissance School of Medicine at Stony Brook University, suggested that the current number of infections still leaves room for improvement.

A positivity rate above 5% which was the figure earlier this week, is “still extremely high,” Clouston explained in an email. “Currently, the [Centers for Disease Control and Prevention] would recommend that no one in the globe travel to Long Island, which doesn’t seem like we ourselves see this as safe objectively.”

Health care providers highlighted the difference between the reported and the actual infection numbers.

When the pandemic started in March of 2020, Dhuper estimates that the ratio of reported to actual cases was close to 1 to 10. With Delta, that number likely dropped to closer to 1 to 5, and with omicron, that’s probably about 1 to 3 or 4.

With the increase in at-home testing, the numbers “we see are more of a sampling, showing the approximate prevalence of COVID-19 virus circulating in the population,” Pigott explained.

Nachman added that Stony Brook is following guidelines from the Food and Drug Administration and the Centers for Disease Control and Prevention when it comes to vaccinations for people who tested positive for COVID-19.

These public health authorities generally recommend a booster dose after people feel well, which is usually 10 days to two weeks after an illness.

Doctors said they are monitoring a new version of the omicron variant, called BA.2

The new variant seems a “bit more” contagious” than the original omicron, Dhuper said. Vaccines, however, have a “reasonable level of protection to prevent hospitalizations and death.”

Dhuper said he continues to “keep an eye” on that variant.

Nachman suggested that the available vaccines continue to help.

“Right now, the [two omicron variants] do not seem to be radically different,” she suggested, as both have a short incubation period and people are protected by the vaccine.

With the number of people contracting the virus and developing more severe symptoms declining, Dhuper said the demand for the effective monoclonal antibody treatment continues to fall.

Dhuper said a recent New England Journal of Medicine study indicated that the antiviral treatment remdesivir, manufactured by Gilead Sciences, was effective at treating mild to moderate illnesses on an outpatient basis over a three-day period.

“Given under controlled conditions, (remdesivir) could be one of the best alternatives that we have,” Dhuper said.

Professor Elio Zappulla, of Stony Brook, 88

Obituaries

by TBR Staff - January 13, 2022

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Elio Zappulla, a long-time Stony Brook resident and dedicated educator, passed away peacefully on Nov. 5, 2021, at the age of 88, due to complications from thymoma.

In 1933, Elio was born in Brooklyn to parents of Italian descent: Giuseppe Zappulla, a radio broadcaster and published poet — originally a stonemason in Sicily — and Rita Fera, a clerk, amateur pianist and swimmer. Upon graduating from Brooklyn’s Midwood High School in 1950, Elio went on to Brooklyn College, where he studied languages and developed his love for teaching. Elio proceeded to teach in Brooklyn by day while pursuing a doctorate in French Literature at Columbia University by night.

Though New York City remained in his heart, Elio relocated to the Three Village area in the 1960s to raise his family. Over the ensuing 60-year period, he encouraged and educated thousands of students at both the primary- and secondary-school levels across Suffolk County. Connecting with young people through his characteristic humor, respect and curiosity, Elio sought to draw the uninterested to the joys of learning, and to challenge his students to lofty goals.

Elio’s love of history, the arts and culture was evident whether working as a foreign-language teacher in the Three Village school district, a teacher/administrator in Huntington or a professor at Dowling College. Outside the classroom, Professor Zappulla acted in, directed and later wrote reviews for local theater productions. Additionally, his polyglot status and voracious appetite for reading made Elio a daily regular at Setauket’s Emma S. Clark Memorial Library, among other bibliophile haunts.

Like his father Giuseppe, Elio was a poet. His magnum opus was a verse translation of Dante’s “Inferno” in 1998. This acclaimed rendition, published by Random House, maintained in English the same rhythmic meter as the original ancient Italian work. Elio worked on this translation as a passion project while teaching full time at Dowling.

Having grown up in racially and culturally diverse parts of Brooklyn, Elio henceforth devoted himself to issues of human justice and equity in American society. He contributed dozens of cogent opinion pieces — infused with his signature wit — to local papers over the years, including Times Beacon Record Newspapers, typically focused on politics and the plight of minorities in America. He aimed to inspire others to also boldly speak up for righteous causes with his actions and teaching.

Elio is survived by Lynette Zappulla, his beloved wife of 53 years, and their two children David Zappulla, of Coopersburg, Pennsylvania, and Eve Anderson, of Los Angeles; and his four young grandchildren. Elio’s first son, Robert Zappulla, lives in Rancho Cucamonga, California, and his elder daughter, Laura Zappulla, predeceased him in 2010.

A private memorial service, due to COVID-19, was held for Elio at Setauket Presbyterian Church on Dec. 22. In lieu of flowers, donations may be made to the American Civil Liberties Union and/or the church.

Between You and Me: COVID-19 came to dinner

by Leah Dunaief - December 9, 2021

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By Leah S. Dunaief

Leah Dunaief

Among the many preparations we made for our family Thanksgiving gathering this year, was carefully considering how to prevent any intrusion by COVID-19, a most unwelcome guest. The children and grandchildren were coming from six different states, so the potential exposure was widespread.

We agreed that everyone would have the appropriate vaccinations, two and a booster if possible. Each member also bought an Abbott BinaxNOW antigen self test result that they took before starting out on their trips. Everyone tested negative, so we were full steam ahead.

Thanksgiving Day was filled with hugs, laughter and love. We had not been all together in almost two years, and much conversation resulted, including how the youngest one had grown. After the traditional sumptuous dinner, we went around the table and spoke about what we were most grateful for in the past year. This is of special value to me, in addition to the lovely feelings of gratitude evoked, because it gives me a chance to catch up on their various activities.

The next day, Friday, we talked, walked, played games and ate some more. I almost didn’t register when one of my grandsons came to the dinner table a little late because he was feeling “achy.” But when he asked for an Advil the next morning, I got out the At-Home rapid test, and in 15 minutes we knew he was positive. Thinking it might be a false positive, we drove him to Stony Brook University Hospital, where he was given a PCR test, the gold standard, and in four hours we had the result.

Somehow, in spite of our careful efforts, the pathogen had found us. We then went to the next step and self-quarantined, but we are still trying to figure out where the hole in our defenses lies. As nearly as we can conclude, a negative test does not check for viruses in low numbers that are just beginning their infection in the nose, for example, and are still too few to register. With no symptoms, there is no way to detect their presence. It typically takes at least three days before the alarm goes off. So even weekly testing, which is so often done by institutions and employers, is not foolproof, especially if the patient is asymptomatic.

Fortunately, because my grandson was doubly vaccinated, the illness was of short duration, although he did lose his sense of taste and smell for a bit. The rest of the family members are fine. But what does that mean for all of us? The potential for infection is there, still with us despite how much we would like to leave it behind and despite all precautions. Gatherings of almost any size carry some risk, especially when we remove our masks to eat together, and we cannot be mindless of the threat.

There may be some good news, however. Omicron, the latest variant to be identified, seems to cause a milder version of the disease, at least so the early evidence indicates. And there are now two different pills that appear to hold back the most harmful effects of the virus if taken within five days of onset. One is from Merck and Ridgeback Biotherapeutics, called molnupiravir, that reduces the risk of hospitalization and death by 30%. It should be receiving FDA approval soon, even though it can cause serious side effects. The other is Paxlovid from Pfizer and so far appears to be 85% effective, perhaps to be authorized by year’s end. Made of a different formulation, it probably would not cause the same side effects as Merck’s but could cause others. Both pills could turn out to be a stop gap if the vaccines prove ineffective against new variants. And both may be more powerful if given together, as research against the virus that caused AIDS proved at that time. According to Dr. Fauci, the government’s top infectious disease expert, who oversaw combination therapy for HIV years ago, such a clinical trial could be quickly done.

Stony Brook holiday favorite returns

by Rita J. Egan - December 6, 2021

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Hundreds filled Stony Brook Village Center Sunday, Dec. 5, for the return of some old favorites.

Last year The Ward Melville Heritage Organization’s Annual Holiday Festival had to be scaled back due to COVID-19 restrictions, and there were no visits with santa, parade and various activities. This year the event returned in full force for the 42nd year. From noon to 6 p.m., the shopping center was filled with activities including performances, music from WALK 97.5, a petting zoo and more.

Attendees were able to stop by Wiggs Opticians to see the holiday train display in the storefront window, and children could visit Santa sitting in front of the post office to take photos and tell him what they wanted this holiday season. This year, Santa sat behind a plexiglass shield to protect him from getting sick.

At 2:15 p.m., a parade led by the Ward Melville High School Band featured the annual Legends & Spies Puppet Procession that included the likenesses of former prominent Three Village residents such as Ward and Dorothy Melville, Anna Smith Strong and William Sidney Mount.

Later in the day, Santa got aboard a holiday float to begin the tree-lighting ceremony and cap off the night on a festive note.

Amid excitement over COVID Pfizer pill, local docs urge boosters

by Daniel Dunaief - November 11, 2021

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N2104P46006H — An antiviral pill may be beneficial in treating COVID-19 in its early stage. Stock photo

When the pandemic first hit Suffolk County in March of 2020, health care providers tried what they could to treat COVID-19.

The treatment options may be on the verge of increasing, as Pfizer recently revealed the benefit of an antiviral pill they developed to treat the virus in its early stages.

The Pfizer pill, called paxlovid, “decreased hospitalization significantly,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases at Stony Brook Medicine. “That’s exciting.”

The Pfizer pill, which would still need Food and Drug Administration authorization before medical care providers can administer it to patients, comes just a few weeks after Merck announced its antiviral pill molnupiravir was effective in treating people who contracted COVID-19.

Indeed, at the end of last week, Britain became the first country to approve the use of molnupiravir for people with underlying medical conditions, including heart disease and obesity.

“There is more information on molnupiravir as this drug was approved in the [United Kingdom] last Thursday,” Dr. Adrian Popp, chair of Infection Control at Huntington Hospital explained in an email. “It will be administered as soon as possible following a positive COVID-19 test and within five days of the onset of symptoms.”

As for Pfizer, it has not yet released data about its clinical trials to the scientific community, which means independent researchers haven’t reviewed the information.

Still, the introduction of new antiviral treatments advances the battle against the virus on another front.

“They are novel medications,” Popp added. “The speed by which they are being developed is amazing.”

Popp added that the pace at which the new Pfizer drug eliminates the virus and its symptoms is unclear because of limited data.

Fries said the Pfizer and Merck drugs were in different classes and worked differently, which means they may be most effective in combination.

In terms of side effects, Fries wouldn’t expect anything dramatic from either treatment.

Taking pills that reduce the severity of the disease also aren’t likely to reduce the body’s natural immunity to the virus.

“The immune system has already seen enough of the virus by the time you take the drug,” Fries said. Some of the patients in the trial probably had the virus for about a week, which is enough time for the immune system to recognize the invader and develop a natural resistance.

The timing of treatment with antiviral drugs determines its effectiveness. Drugs like Tamiflu, which prevents the worst symptoms of the flu, become less effective the longer the virus is in a patient.

“If you give this drug later, it will likely have less effect,” Fries said.

Additionally, Fries cautioned about overusing these drugs in future months and years, which can lead to viral resistance.

Fries believes the virus, like the flu, will continue to stick around and will return in waves.

The authorization of vaccines for children ages five to 11 will likely reduce the threat from the virus.

“A lot of parents will schlep their kids right away, especially before Thanksgiving,” Fries said. “Physicians and people who have a deeper understanding of vaccines feel comfortable” with them.

Fries recently received her third shot.

While the likelihood of children developing the worst symptoms of the disease is low, they contribute to the spread of the virus.

Additionally, the virus can mutate, which could make it “potentially a lot worse. There is [also] a low but potentially significant risk of long covid syndromes,” Fries said. “You don’t want your kid to have that. Children should be super duper healthy, not just a little bit healthy.”

Thanksgiving preparation

In terms of preparing for Thanksgiving, Fries urged everybody over 65 to get a booster, particularly if they received their initial vaccines at least six months ago.

Stony Brook Hospital is admitting patients who have been vaccinated and are over 65, in part because their initial vaccinations were over half a year ago.

“We see more and more older people presenting with the disease again,” Fries added. “Do it now so you have antibodies for Thanksgiving” particularly if a family has children returning from college.

Additionally, Fries urged residents and their families to get tested before coming together, which will reduce the risk of household transmission.

Even though Pfizer and Merck have produced drugs that may improve the treatment of COVID-19, Fries urged people to continue to get vaccinated.

“This kind of drug treatment does not make us say, ‘Okay, you don’t need to get vaccinated,’ Fries said. “Absolutely not.”

Fries noted that those people unwilling to receive an mRNA vaccine might get another option before too long.

The Novavax vaccine has “performed really well” in clinical trials, Fries said. “It is more of a traditional vaccine.” The Novavax facilities have had production problems. Once they resolve those issues, the company could apply for emergency use authorization.

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