Many Illnesses Carried by Ticks Share Symptoms with COVID-19
A deer tick is a common type of tick on Long Island. Stock photo
With summer close by and as New York State continues to relax shutdown restrictions, residents will naturally want to get some fresh air. But while open spaces like parks and nature preserves provide a temporary reprieve from the COVID-19 pandemic, they are also home to ticks. These arachnids can carry Lyme disease and other serious tick-borne illnesses. Experts say this is the time when ticks are most active and when their numbers increase.
“We have already passed a month of tick activity here on Long Island,” said Jorge Benach, distinguished Toll professor of Molecular Genetics & Microbiology and Pathology at the Renaissance School of Medicine, Stony Brook University. “With minimal contact because people were staying indoors due to the pandemic, we have seen less cases.”
Benach said that could change in the coming summer months, especially with an already large tick count this year. Currently, we are entering the second phase of tick season, which is when the arachnids are in the nymph stage and are harder to spot.
“For some reason Long Island has a heavy population of ticks,” Benach said. “It has the perfect environment for them and they really thrive.”
Three species of ticks call Long Island home. The deer tick can carry Lyme disease, anaplasmosis and other illnesses, while American dog tick can carry Rocky Mountain spotted fever. The lone star tick can transmit tularemia and ehrlichiosis.
“The lone star tick, we believe, is the most aggressive of the three species, and we didn’t know it existed until 1980,” the distinguished professor said. “And then it somehow found its way to Long Island.”
A 2019 study, headed by Benach and Rafal Tokarz, assistant professor of epidemiology at Columbia University, with co-authors from SBU and Columbia, found prevalence of multiple agents capable of causing human disease that are present in three species of ticks in Long Island.
Another concern this season is that tick-borne illnesses like Lyme disease and anaplasmosis have symptoms that overlap with those of COVID-19, including fever, muscle aches and respiratory failure, but without persistent coughing.
“It is true that they have overlap in the initial symptoms, but once you get past that first stage it should be easier to diagnose if that person has a tick-borne illness,” Benach said.
Tick-borne diseases are usually treated with antibiotics. The effects range from mild symptoms that can be treated at home to severe infections that if left untreated can lead to death in rare cases.
The distinguished professor stressed the need for people to be aware of ticks when they are in certain areas outdoors.
Repellents and wearing long-sleeve pants and shirts can be good deterrents for ticks. Other tips include walking along the center of trails, washing and drying clothing when you come home and keeping pets from areas that could be tick infested.
Benach said there is a misconception that humans get ticks from dogs. Instead, it is more likely one gets a tick from being in the same space as your dog.
“You should be checking yourself, and if you spot a tick get it off as soon as possible,” he said. “If you develop any symptoms or illness contact your doctor.”
In a milestone indicative of how deadly and prolonged the toll of the virus has been, Suffolk County reported the first day without a death from COVID-19 since March 16.
“I’m finally able to say that no one in Suffolk County in the last 24 hours has died from COVID-19,” County Executive Steve Bellone (D) said on his daily conference call with reporters. “That’s a great place to be.”
While Bellone said the county, which entered Phase Two of its reopening Wednesday, June 10, still has a ways to go before it controls the spread of a virus that has claimed the lives of 1,945 people in the county, the day without a death from the pandemic is a “milestone.”
With many other states, including Texas and North Carolina, are experiencing a surge in the number of people diagnosed with the virus and being admitted to hospitals for their care, Suffolk County continues to experience a decline in the number of residents testing positive.
Indeed, in the last day, despite protests over the death of Minneapolis resident George Floyd at the hands of a former police officer charged with murder, the number of people who tested positive in the county only increased by 47, raising the total to 40,559.
Bellone attributed the current condition on Long Island to the pain, uncertainty and suffering that rocked Long Island, which was the epicenter of the pandemic in the country.
“Because of the experience we’ve gone through, overwhelmingly, people are taking precautions,” Bellone said. “They are still listening to the guidance. Even at protests, even at demonstrations, I have seen people wearing face coverings.”
Suffolk County also has an advanced testing and contact tracing system that is making a difference as the area reopens.
Meanwhile, earlier today, Governor Andrew Cuomo (D) signed an executive order requiring local police agencies to develop a plan that reinvents and modernizes police strategies and programs in their community based on community input. Each police agency’s plan must include procedures and practices that extend beyond the use of force by April 1, 2021.
The police forces have to engage the public in the process, present a plan for comments, and share that plan with a local legislative body. If the government doesn’t certify the plan, the police may not be eligible to receive future state funding.
Bellone said he “looks forward to working with the state” on community police policies. The county executive said he is proud of the work the Suffolk County Police Department has done with anti-bias training.
The SCPD has “developed leading edge initiatives.”
Cuomo also signed a bill passed by the state senate earlier this week repealing 50-a, a statue in civil law that prevented people from accessing records of police and other civil servants like firefighters. Advocates said this will allow more transparency, especially regarding police misconduct. Police unions and senate republicans said this would puts cops in more danger, despite proponents saying people cannot gain access to cops’ personal information.
Bellone reemphasized a point he has made in recent days amid the backlash against unjust and unfair policing polices, suggesting that the police are “part of the community, they aren’t coming into the community” from the outside.
Police Commissioner Geraldine Hart said she met this morning at 11 a.m. with the President of the Guardians, which is an internal fraternal organization representing black officers. She meets with the Guardians on a monthly basis.
Officers in the Guardian “know they have accessibility to leadership,” Hart said. “Those conversations lead to suggestions.”
The discussion this morning was more informal and was part of an open conversation and dialog.
As for the impact of COVID-19 in the county, the numbers continue to show a hard-fought recovery from the deadly virus.
Hospitalizations in the 24 hours ending on June 10 declined by 17 to 134. The number of residents in the Intensive Care Unit also declined by four to 41.
“These are all great numbers,” Bellone said.
An additional 16 people were discharged from hospitals in the county.
The bed capacity remained below important levels. Residents with COVID-19 represented 66 percent of the overall beds, and below 60 percent of the ICU beds, which are below the 70 percent guidance offered by the Centers for Disease Control and Prevention.
The county handed out 17,000 pieces of personal protective equipment over the last day.
Finally, the county worked with Island Harvest to distribute food through a program called Nourish New York today.
The effort, which was at the Westfield South Shore Mall in Bay Shore, planned to distribute 100,000 pounds of food, including cheese, milk, yogurt, fresh fruit and vegetables and ground beef.
The program “helps those in this desperate time who need food” while preventing waste and supporting the agricultural community, Bellone said. Through 2 p.m., the program had handed out more than 2,500 boxes of food items.
New York may have started Phase One of its reopening and other states may have reopened shops and businesses, but life won’t change much for Angie Tempio.
A native of Commack who had been working at the front desk at Funt Orthodontics in Setauket since 2017, Tempio received a heart transplant last summer and plans to do everything she can to protect herself amid threats from the pandemic.
Tempio, who was preparing to rebuild her life outside of an apartment she shares in Yaphank with her boyfriend James O’Brien, plans to remain as isolated as possible, lowering the chance of contracting COVID-19.
Angie Tempio with her boyfriend James O’Brien
“The world is opening back up,” Tempio said. “For me, it’s not. Nothing will change for a few months. I’m used to being left behind.”
Tempio, however, doesn’t feel sorry for herself or rue her situation. She now focuses on new possibilities.
Diagnosed with restrictive cardiomyopathy when she was 11, she slowly went into heart failure. She struggled for a few years before her transplant, but the last year was the toughest. She said her pacemaker kept her alive.
Tempio, who recently turned 26, had made her peace with death, particularly when she struggled to walk two steps at a time and when her failing heart beat only 30 times per minute. “I was lucky,” she said. Two months after she went on the transplant list, she “got the call, which is a miracle in itself.”
While Tempio feels overwhelmingly blessed that she can consider having children, she said she is also sensitive to the over 1,870 residents who died from COVID-19 in Suffolk County.
Tempio had a rare heart condition that caused her to be a small statistic. Even with the overall mortality rate for COVID-19 below one percent, she empathizes with people and their family who are on the other side of those small numbers.
“Experiencing being a small statistic has definitely made me look at things differently,” she said. “In my head, anyone can [be such a statistic] and most people aren’t realizing that and that’s what’s making me overly cautious.”
Tempio said she was a gymnast and was seemingly healthy before she developed the rare heart disease.
“Although I haven’t experienced the virus itself, I’ve been through the same obstacles,” she explained in an email.
Even when the coronavirus first started infecting people on Long Island, Tempio wore masks to the classes she is taking at Suffolk County Community College, where she hopes to study to become a transplant coordinator. She said she felt judgment from people who thought she was being overly concerned about the virus.
“Most people didn’t realize” how much more vulnerable she was to the virus than the typical person walking around Long Island, she said.
While she’s waiting for the moment when she can emerge from a home cocoon, Tempio has been connecting with a network of friends and a close-knit heart transplant support group. She and 13 others are a part of a group that shares a profound and unique experience that brings them together and helps them connect with, and support.
“They have been my outlet during one of the hardest times in my life and I am so grateful to have them,” she said.
Tempio said she feels a responsibility to live her best and healthiest life. She believes she is “now living for my donor,” she said, and plans to “take the best care of this heart that I can.”
Dr. Frank Darras, Clinical Professor of Urology and Clinical/ Medical Director of the Renal Transplantation Program at Stony Brook University Renaissance School of Medicine Hospital, has performed over 1,700 kidney transplants since 1990.
This year has been especially challenging for the surgeon, as he has had to enhance safety procedures to protect patients who are on immunosuppressants during the COVID-19 pandemic.
As part of the new normal for kidney transplants, Stony Brook takes time to test patients for coronavirus. In the first few weeks after the virus hit Suffolk County, the tests took all day. In recent weeks, the labs have produced test results within one to three hours.
Through late April, Darras said the hospital hasn’t had to send anyone home who had a positive COVID-19 test.
The long-term effects of COVID-19 on the function of normal kidneys is difficult to predict, he said. Many of the patients with the most severe symptoms from the virus not only needed ventilators, but also needed dialysis treatments. In the majority of cases where people recovered from the virus, their kidneys also recovered.
The hospital has also seen patients who received kidney transplants who have contracted the virus. “Several of these [transplanted patients] had diminished function, but all of them recovered their kidney function,” Darras said.
The longer-term effects of the virus are unknown. Some patients who were severely ill may have recovered, but have kidney problems that slowly escalate over time.
“I would not be surprised to see that happen, whether that’s months or years down the road,” Darras said.
Another unknown is how the virus would affect the transplant community in the longer term. “In the worst case, it’ll make our living donor pool smaller,” he said. About one out of three kidney transplants comes from a living donor. “On the other hand, in the best case scenario, [the virus will have] relatively little impact. It’s too early to tell,” he added.
According to Darras, people who need kidney transplants can extend their life expectancy by two to three times. He estimated that about five to six percent of the people waiting for a transplant died while on a kidney waiting list.
Darras explained that “time is of the essence” for many patients because the “longer patients are on dialysis, the more urgent [the need] to get them transplanted,” and added that finding donors is critically important, particularly during the pandemic.
“There is a concern about trying to make sure that we can get enough kidneys,” he said. “Our job and the job of LiveonNY is to raise awareness about organ donation.”
Yolanda Reed-Anthony took this selfie 15 minutes before her transplant.
By Daniel Dunaief
Yolanda Reed-Anthony’s grandparents, Dr. Frank Darras, and an anonymous donor likely saved the life of this devoted wife, mother, and daughter.
In the midst of the COVID-19 pandemic, which forced Governor Andrew Cuomo (D) to shut down most of New York’s economy and limit hospital activities to emergency procedures, Reed-Anthony had an unusual dream. In the dream her late grandparents, William and Rose Evans, brought her a white box. When she opened it, multicolored butterflies fluttered around her.
Intrigued by the dream, Reed-Anthony read that it suggested a new transition in life.
Sure enough, later that day, the Holbrook resident received the kind of call her brother Richard Reed, Jr. and her father, Richard Reed had gotten for themselves: a kidney was available, thanks to an anonymous donor who was a match for her.
The family has struggled with a kidney condition known as focal segmental glomerulosclerosis (FSGS), which necessitates the use of dialysis at least twice a week.
The timing for Reed-Anthony made the decision about whether to accept the incredibly rare gift of a new organ problematic. “The thought” of passing up the kidney on March 12, in the midst of the pandemic “crossed my mind, but I quickly dismissed it because of the dream,” she said in a recent interview.
Yolanda Reed-Anthony with her brother Richard Jr. after his kidney transplant in January.
Reed-Anthony entered Stony Brook University Hospital, where Dr. Frank Darras, the Clinical Professor of Urology and Clinical/ Medical Director of the Renal Transplantation Program at Stony Brook Renaissance School of Medicine, awaited, along with a transplant team.
As Suffolk County became an epicenter for infections, with the number of sick in hospital and Intensive Care Unit beds increasing, people in need of organs faced increasingly difficult odds of finding a life-saving organ.
For starters, every person who became sick or died from COVID-19 was immediately ineligible to be a donor. Without effective treatment or a cure for the virus, the transplantation of an organ from an infected person into someone who needed the organ but likely couldn’t survive the infection raised the risk of such an operation above the benefits of the procedure.
The immunosuppressant drugs each organ recipient takes after the operation reduces the likelihood that the person will reject the organ. These drugs also, however, raise the chance that an infection of any kind, much less a lethal virus, would threaten the health and life of the recipient.
Reed-Anthony said the Stony Brook staff let her know that the hospital process would be different even than for her brother, who received his kidney in January.
The doctors and nurses made sure no one who wasn’t supposed to be in her room entered. “They were like secret service for me,” Reed-Anthony said. “They took precautions for me that were different than for my brother and father,” adding that she was well aware of the viral struggle that so many others in the hospital were enduring at the same time. She was in the hospital for five days by herself, with no visitors other than the medical staff.
Reed-Anthony said the staff was ad-libbing in the precautions they took with her, minimizing the risks during her period of extreme vulnerability. Several days after surgery she needed to walk, which is something her brother and father did up and down the hospital hallway. She never left her room, circling from the bed to the window to the bathroom at least six times.
Yolanda Reed-Anthony with her father Richard after his kidney transplant.
The social workers, meanwhile, stood by the door to ask questions, while the dietician wasn’t allowed in the room, with the nurses bringing the food tray in and out of the room.
Dr. Darras, who performed the surgeries for Yolanda, her father and brother, explained that the transplant team understood and appreciated the extreme demands COVID-19 placed on Stony Brook University Hospital and on the health care system throughout Long Island.
“We knew we had to work within the framework of the administration and the hospital to try to do what we needed to do for our patients without infringing on the big picture,” Darras said. “We knew we had to be good team players because every department had to have a redeployment of staff into other areas of the hospital.” Still, within the unprecedented needs of the rest of the hospital, the transplant team still felt like they could do what they needed safely for patients working against the unkind ticking of a clock.
While it took significant effort to find safe areas for the transplant group to use, Darras and other surgeons performed life-enhancing and saving surgeries in the midst of the COVID-19 firestorm.
Indeed, Darras led one of the transplants at 3:30 am on a Saturday night, when so many of the staff might otherwise have been sleeping, relaxing or stepping away from the intense health care drama that surrounds them. The mood in the room, however, was positive.
“Everybody that was involved felt that it was a really happy moment,” Darras said. “You couldn’t have found a happier group of people.”
The health care workers appreciated the opportunity to use their training towards a positive outcome. “Out of being in the fire, something good was happening,” said Darras. “It was a happy surgery. It gave people a reprieve and they wanted to do this again.”
Darras appreciates the heroic efforts of so many of his colleagues, who have done yeoman’s work in the face of the pandemic. He also believes the efforts of the transplant teams were heroic in taking care of patients who had life-altering surgeries in a unique environment.
At the same time that doctors and support staffs found safe places for these procedures, LiveOnNY, which is the nonprofit organ procurement organization for New York City, Long Island, Westchester and the lower Hudson Valley, has struggled to find donors during the pandemic.
For starters, everyone who contracted the virus became ineligible to donate an organ. Even those people who had filled out organ donor cards couldn’t save or extend the lives of others if they had the disease. “With so many deaths related to COVID, the potential for organ donation has been drastically reduced,” Helen Irving, the CEO of LiveOnNY said. In January and February, LiveOnNY was involved with 51 organs donations each month. In March, that number surged to 67. In April, as New York reached its viral peak, the number of organ donations fell to 10.
While Stony Brook University Hospital performed organ transplants during the pandemic, other donation programs slowed or stopped due to the virus. That is starting to normalize now, according to LiveOnNY.
Irving said the reduction in the ability to perform these operations is “quite devastating.” She has been acutely aware of the hospital deaths during the pandemic. New York State law requires hospitals to call any death into the organ procurement organization. At one point, LiveOnNY was receiving over 600 calls each day, when the normal number is closer to 150.
Additionally, with people avoiding the hospitals, even when they might have life-threatening conditions, the potential for organ donation also declines.
In normal times, LiveOnNY receives about 12 referrals per day from cardiac arrests or strokes. During the peak of the pandemic in early April, they averaged four. “If someone dies at home, there is no potential there to be an organ donor,” Irving said, although they can become a tissue donor.
Through the pandemic, Irving suggested that LiveOnNY will continue to search for the needle in a haystack that saves or extends someone’s life. The nonprofit is a part of a network that extends across a wider geographic area beyond New York. The group is part of 58 organ procurement organizations nationwide.
Irving encouraged New Yorkers to sign up to become donors, particularly in a post-COVID world. Typically, she would be making the case for signing up to become organ donors through community events. At this point, however, most of those events are no longer being held because of limitations on large gatherings.
“We have to educate the community that needs to know that organ donation is still possible,” Irving said. “Patients can’t wait on a transplant list. That message is far more important today than ever before. You can save someone’s life by signing up on the registry.”
People who would like to sign up can do so through the LiveonNY.org web site, by calling (866) NY-DONOR (693-6667) or through [email protected].
Organ donations were “always a miracle to begin with,” Irving said. “Now we’re asking for a bigger miracle.”
Reed-Anthony has signed up to be an organ donor herself. She is prepared to donate any organ a recipient might need. After all she and her kidneys have been through, she suggested those organs might not be the best choice.
Bruce Stillman, the CEO of Cold Spring Harbor Laboratory, last week won the Dr. H.P. Heineken Prize for Biochemistry and Biophysics, which is considered the most distinguished scientific prize from the Netherlands.
The prize, which has been awarded to 13 researchers who have gone on to win Nobel Prizes, includes a $200,000 award and a crystal trophy.
Stillman earned the award, which began in 1964 and is given every two years in categories including Medicine, Environmental Sciences and History, for his decades of work on mechanisms involved in the replication, or copying, of eukaryotic DNA.
The understated Stillman, who was born and raised in Australia, expects he’ll put the prize money into a foundation, although he hasn’t thought much about it given the other concerns that dominate his time, including not only running his own lab amid the COVID-19 pandemic but also overseeing a facility where he has been the Director since 1994 and its CEO since 2003.
Stillman said the lab has had “extensive discussions” among the faculty about whether to pursue additional research fields on an ongoing basis to combat the current virus as well as any future public health threats.
While CSHL is not an infectious disease center, the facility does have a historical precedent for contributing to public health efforts during a crisis. Indeed, during World War II, the laboratory helped create a mutated strain of fungus that increased its yield of the drug penicillin.
At this point, CSHL does not have a high containment facility like Stony Brook University where it can handle highly infectious agents.
“We may have to have one here,” Stillman said. “The reality is there are tons of infectious diseases” and the lab might need to repurpose its scientific skills towards coming up with answers to difficult questions.
Even without such a Biosafety Level 3 designation, CSHL researchers have tackled ways to understand and conquer COVID-19. Associate Professor Mikala Egeblad has been exploring whether neutrophil extracellular traps, which are ways bodies fight off bacterial infections, are playing a role in blood clotting and severe respiratory distress.
These NETS may be “promoting severe symptoms in COVID,” Stillman said. Egeblad is working on a case study with several other collaborators who have focused on these traps. Egeblad is also studying the effectiveness of NETS as a biomarker for the most severe patients, Stillman said.
CSHL is also investigating a small molecule compound to see if it inhibits viral infection. Researchers including Assistant Professor Tobias Janowitz are about to participate in a combined Northwell Health-CSHL double blind study to determine the effectiveness of famotidine, which is the active ingredient in the ulcer-treating medication Pepcid.
The coronavirus treatment, which will include patients who don’t require hospitalization, would require a higher dose than for heartburn.
As a part of this study, the scientists will use a patient tracking system that has been used for cancer to determine the effectiveness of the treatment through patient reporting, without requiring laboratory tests.
Stillman is pleased with how CSHL has “repurposed ourselves quickly, as have many institutions around the world.” He highlighted the constructive interactions among scientists.
The public health crisis has “generated a different kind of behavior in science, where there’s a lot of interaction and cooperation,” Stillman said. The preprint journal BioRxiv, which CSHL operates, has had nearly 5,000 papers about COVID-19 since January. The preprints have “not only helped disseminate information rapidly [to the scientific community], but they are also “being used to determine policy by government leaders.”
Stillman urged scientists to apply the same analytical technique in reading preprinted research that they do with peer-reviewed studies, some of which have required corrections.
As for the government’s response, Stillman believes a retrospective analysis will provide opportunities to learn from mistakes. “I don’t think the [Centers for Disease Control and Prevention] has done a very good job,” he said. He suggested that the well-documented problems with the roll out of testing as community transmission was increasing, was a “disaster.”
The CSHL CEO also said the balkanized medical system, in which every state has a different system and even some local communities have their own processes, creates inefficiencies in responding to a fluid and dangerous public health crisis.
Coordinating those efforts “could have been done very, very rapidly to develop a modern, clear [polymerase chain reaction] test of this virus and yet states and federal agencies had regulations about how these tests can be approved and controlled and regulated that are far too bureaucratic and did not set a national standard quickly,” he said.
He hopes agencies like the CDC, FDA and the Biomedical Advanced Research and Development Authority have better coordination. The country needs a national response, like it had after the Homeland Security effort following 9/11.
Optimistically, Stillman expects a therapeutic antibody will be available by the end of the summer to treat COVID-19. The treatment, which will use monoclonal antibodies, will likely be injectable and will be able to prevent infection for a month or two. These treatments could also help limit the severity of symptoms for people who have been infected.
Regeneron has taken the same approach with Ebola effectively. Stillman doesn’t think such treatments can be used with everybody in the world, which increases the need to develop a vaccine. Creating a safe vaccine, which could be available as early as next year, is a “massive, under-recognized undertaking.”
Between now and next year, a second wave of the virus is certainly possible and may be likely, given that other coronaviruses have been seasonal.
“This happened with the influenza pandemic a century ago, so we have to be careful about this,” Stillman said. He believes that the medical community has learned how to treat severe patients, which should help mitigate the effects of a second wave in the United States.
That may not be the case in developing countries, which is a “concern,” he said.
Dr. Kenneth Kaushansky, the dean of the Stony Brook Renaissance School of Medicine at Stony Brook University, is eager to restart the educational mission of training medical school students.
Dr. Kenneth Kaushansky, the dean of the medical school at SBU, said there’s a real possibility of a second wave of COVID-19. File photo
While Gov. Andrew Cuomo (D) has said that medical schools can restart on June 22, Kaushansky has asked for a waiver to allow students to continue to build on their clinical knowledge sooner.
“I was worried about the delay in doing the experiential learning,” Kaushansky said. A delay that lasts too long could push graduation back for the rising fourth year students, which is “not good for any health care professional. We need health care professionals, including respiratory therapists, physical therapists, nurses and social workers” among others.
On top of the need to ensure on-time graduation for the Class of 2021, he said another wave of the COVID-19 crisis will increase the demand for graduates.
The medical school dean said Stony Brook University Hospital is watching carefully the protests over the death of Minneapolis resident George Floyd at the hands of a police officer charged with his murder. The hospital and staff are ready in the event of a spike in demand for health care after large gatherings on Long Island and in New York City.
“We are ready to mobilize on a moment’s notice because we did it the first” time, albeit with numerous questions about the course and potential treatment for the new virus, Kaushansky said.
On Saturday, he sent out a letter to the health sciences community addressing what he termed “health care racism.”
“We witnessed the sum of all these effects in the disproportionate lethal burden of COVID-19 on communities of color, a combination of overcrowding at home, of jobs that do not allow the protection afforded by work from home, or from the disproportionate burden of health care conditions that arise, in part, from health care disparities,” he wrote in the letter. He urged the Stony Brook community to “do everything in our power to work toward erasing the social determinants of disease that contribute to our unequal society.”
He urged learners and critical staff to develop and practice cultural sensitivities, and he also suggested that the school should make “certain our graduates reflect the diverse society in which we live.”
In its admission decisions, SBU includes the notion of overcoming hardship as a part of the process through which the school evaluates prospective students.
In the coming years, Kaushansky plans to emphasize further the importance of encouraging those who have faced significant hurdles in applying to the medical school.
In terms of treating patients who have COVID-19, he is encouraged by the use of remdesivir and convalescent plasma. The school has these treatments available for people who are sick and is studying the effectiveness of these approaches.
More than 1,500 patients have been admitted through the university hospital, Southampton and Eastern Long Island hospitals and have benefited from the clinical study of symptoms including clots.
Surgeons had noticed that D-dimer levels, which are proteins that indicate the presence of clots, were shooting up. They decided when this protein reached a certain level, they would use a full dose of anticoagulants.
Stony Brook has put the results of these aggressive anticoagulant treatments into an article that has been submitted for publication.
In the meantime, the university has taken an across-the-board approach to raising anticoagulants.
“That will improve the mortality rate should we get a second wave,” Kaushansky predicted.
In the event of a second wave, Stony Brook Hospital and, indeed, New York will be better prepared, with more tests, greater awareness and contact tracing.
Kaushansky believes that the people who have already fought off the virus are presumably immune from getting it a second time. What’s unclear, he explained, is whether the antibody test is predictive of resistance. Additionally, it’s unclear how long that resistance will last.
He expects that monoclonal antibodies can work, but that they should be reserved for the sickest patients. They are expensive and are hard to produce the level necessary for the U.S. population of more than 300 million people.
What worries the Stony Brook dean is that people have had enough of staying at home, social distancing and wearing masks. In the worst of the crisis, when the numbers of people sick and dying were climbing, Kaushansky could get to work in much less time than normal, as traffic on the roads had lightened up considerably.
Days before the Phase 2 reopening, which began on Wednesday of this week, the level of traffic has returned to a more normal density.
Meanwhile, Phase 2 for Stony Brook University involves reopening research laboratories and allowing people who were previously deemed nonessential workers to return to the labs in an “orderly and safe fashion,” Kaushansky said.
The university has installed plexiglass shields, requires social distancing, built partitions between people who don’t have their own offices, and requires everyone to wear masks and have their temperatures taken when they come to work.
The hospital opened up for elective surgery two weeks ago. Everyone who is scheduled for surgery has to get a viral swab the day before.
The approach the university has taken in requiring personal protective equipment and social distancing has paid off for hospital staff who have been exposed to all those sick patients. The rate of antibody tests of employees is much lower than in the general community.
“It’s safer to be a frontline health worker at Stony Brook than to work at some grocery stories,” Kaushansky said.
On the clinical side, he believes Stony Brook Hospital needs more highly skilled nurses. At the peak, the university hospital had 437 patients. If it had reached 500, “we would have been in trouble,” he added.
Upstate New York had sent 20 experienced nurses to help out.
“Nursing is important and high-level nursing, operating-room nursing, was particularly stressed,” Kaushansky said. “We need to hire more nurses.”
He added that the school trains excellent nurses and plans to hire some of its own graduates.
In terms of medical school classes, the dean said the university hasn’t decided yet whether to bring small groups back together. The big lecture halls will still involve remote teaching.
“Are the smaller group educational exercises going to be back safely?” he asked. “I’m working to make that happen.”
Kaushansky takes solace in the way PPE reduced the infection rate for the hospital as a whole, and believes such an approach could work for medical school classes as well.
Even as Phase Two of the economic restart began yesterday, County Executive Steve Bellone (D) said he has reached out to Governor Andrew Cuomo’s (D) office to request the restart of other activities.
Bellone has asked that youth sports be permitted. He said he also would like to see non-touch museums that have large spaces with capacity limits reopen.
“Some of that was lumped into Phase Four with mass gathering-type activities,” said Bellone on his daily conference call with reporters. The county is looking at what it can open up sooner.
Bellone, who spent parts of the first day of Phase Two getting a haircut, dining out and enjoying ice cream with a tour of several downtowns in Suffolk, said the reopening was “off to a good start” and that it helped people feel more of a sense of normalcy.
Bellone reminded business owners that the county started a personal protective equipment giveaway.
The county is providing some cloth face coverings and hand sanitizer to small businesses, nonprofit companies and faith based organizations.
“Reopening businesses in this environment is a challenge,” Bellone said. “To the extent we can do something that helps them a little bit, we want to do this.”
Bellone said 403 businesses had filled out applications for those supplies since Monday and that 226 businesses had picked up those kits. Interested business owners can find a supply request form at suffolkcountyny.gov/bru.
Viral Numbers
Over the last 24 hours, an additional 48 people have tested positive for COVID-19, which brings the total to 40,512. The county executive hopes that number continues to remain below 100 for any given day.
The number of new infection numbers continues to remain below 100 despite protests in response to the murder of Minneapolis resident George Floyd.
Bellone said it might still be a little early to draw any conclusions about the potential spread of the virus in response to the protests. He will be looking more closely at the new infection rates through the weekend and into the beginning of next week.
“My sense is that being outdoors is a safe environment,” the county executive said.
For the 24 hour period ending on June 9, the number of people in hospitals with COVID-19 declined by 14 to 151. The number of people in Intensive Care Units declined by one to 45.
Hospital bed occupancy from people with the coronavirus stood at 66 percent for hospital beds overall and at 60 percent for ICU beds.
An additional 15 people were discharged from the hospital and are continuing their recovery from the virus at home.
Meanwhile, the number of people who died from complications related to COVID-19 increased by four in the last day. The total for the same period ending yesterday was two, which brings the total to 1,945.
The county distributed an additional 26 pieces of personal protective equipment over the last day.
From left, Port Jeff chamber president Mary Joy Pipe, Suffolk County Executive Steve Bellone, Salon Blonde owner Melissa Hanley, Mayor Margot Garant celebrate the start of Phase Two reopening June 10. Photo by Kyle Barr
With Phase Two reopening coming to fruition Wednesday, June 10, Port Jefferson village has looked for several ways for business owners to get their wares and services outside.
Debra Bowling, owner of Pasta Pasta in Port Jeff, set up tables outside for Phase Two reopening. Photo by Kyle Barr
Village officials have already talked about setting up areas in parking lots to allow for more outdoor dining space. At its June 1 meeting, the village voted to waive all dining table application fees for the upcoming season. Mayor Margot Garant said the village has been working with a host of restaurants to figure out how they may go about offering outdoor services.
The mayor said the village is allowing space for restaurants who normally have no space for outdoor dining in right-of-ways, walkways and parking lots.
By midday Wednesday, the town was jiving. With a steady stream of cars rolling down Main Street, and with customers sitting under canopy eating outdoors, many owners said Phase Two was turning out to be a much better scenario than Phase One.
During a tour of Suffolk downtowns, including Port Jeff, County Executive Steve Bellone (D) said the difference in allowing construction in the first reopening phase and allowing salons or outdoor dining has been significant.
“After going through an unprecedented event, these are the activities that give people a sense of normalcy,” Bellone said.
Restaurants are setting up in formerly public places, such as Ruvo East and Old Fields which are laying tents in the space behind their restaurants. C’est Cheese and The Pie are also doing outside dining behind the main building on Main Street. Prohibition Kitchen will be using the parking lot behind its building as well.
Manager of The Pie, Jessica Janowicz, said though they will be setting up a tent behind the business Friday, each week has seen a slow progression in sales. Wednesday showed a big difference, with a steady stream of customers doing takeout since the place opened.
Other restaurants will be using pedestrian walkways for its outdoor space, including Salsa Salsa, which will have some space in the alleyway next to the shop. Pasta Pasta and Toast Coffeehouse are laying out tables at the top of the stairway along East Main Street.
Debra Bowling, the owner of Pasta Pasta, thanked the Port Jeff chamber and the village for working so quickly with permits and signage. Her restaurant now has several tables and a flower box in front of her shop, and in over 30 years of working there, it’s the first time she has seen it do outdoor dining.
Alana Miletti of Fame and Rebel speaks about Phase Two with County Executive Steve Bellone. Photo by Kyle Barr
Some restaurants that have access to the outside, including Nantuckets, Gourmet Burger Bistro, The Steam Room and SaGhar, will use their current outdoor space as long as it can be open up to the sky. Danfords has its outdoor space on its dock and now has an agreement with the Town of Brookhaven for some use of the Mary Bayles Waterfront Park.
A member of the village fire marshals did not respond to requests for comment about guidelines for safety in walkable areas.
The Greater Port Jefferson Chamber of Commerce released a letter dated June 5 to the Village of Port Jefferson mayor and trustees asking that retailers be allowed some latitude for “outdoor merchandising.”
“The consumer would have the ability to ‘shop’ in a less confined area and the retailer would be creating more opportunities for sales,” the letter states.
Director of operations for the chamber Barbara Ransome said she has had positive feedback from village trustees on the proposal.
Garant said they are working up guidelines that should be released sometime on Wednesday, but those were not available by press time. Retailers will have the option to have a table in front of their shops, but they will need to keep 3 feet of sidewalk clear and ensure that they do not block doorways or fire exits, as mandated by U.S. Centers for Disease Control and Prevention guidelines for outdoor dining.
Code Enforcement will be inspecting businesses and restaurants to ensure they’re not blocking too much of the curb or that they’re adhering to the CDC distancing guidelines.
“We’re trying to keep it so that it’s nice looking and it’s not an overload of stuff,” Garant said.
Alana Miletti, the owner of the boutique shop Fame and Rebel, said she has survived in the grueling months of the pandemic thanks to her active social media helping facilitate online orders. Though on Wednesday she said with customers able to browse, even in a limited capacity, she had not had a moment’s rest fulfilling orders since the store opened.
“People couldn’t wait to come out,” she said.
Now with Phase Two salons and haircutters are finally able to open. Melissa Hanley, the owner of Salon Blonde, said she managed to survive during the nearly three full months she was shut down thanks to federal loans. Being back in action, however, means a world of difference.
“It’s been scary — we’ve been struggling a little bit,” Hanley said. “It’s such a relief. This is my life so, to be back in business, I’ve waited a long time for it.”
Hi, welcome to my store. It’s so good to see you after all these years. It hasn’t been years, I know, but it just feels like it because I’ve been a prisoner at home with my teenage children who have decided they are allergic to cooking, cleaning or almost anything else that has to do with helping around the house.
But, hey, this isn’t about me, it’s about you. You’re looking well, thank goodness. That’s the most important thing, right? This virus has been so hard on everyone, but I promised I wouldn’t say anything about the virus today.
Anyway, we have decided to move to a high touch environment because we can only have two people in our store at a time and one of them is me, which means you’ll have to leave the child you’re carrying in the stroller outside.
You don’t have a stroller? No problem. I have a disinfected stroller just for this occasion that I can bring out from the back for you. In fact, I’m happy to sell it to you at a bargain price because I haven’t sold much of anything these days. I tried selling food to my teenage kids, but they just said I was a terrible cook, they weren’t hungry or they would be in their rooms and I shouldn’t bother them until 2021.
Oh, wait, there, I did it again. I’m so sorry. Silly me, I’m talking about myself. And, whoops, I see from your frown that you’re not happy I touched your shoulder when I made that joke. I have to make sure I socially distance. In fact, I have this new touch-the-shoulder-in-a-joking-way stick that’s exactly six feet long which I would also be happy to sell to you. I know it looks like two yard sticks taped together, which it kind of is, but it guarantees that you’ll be six feet away from everyone else.
Yes, of course, I’m fine. Why do you ask? I’m so happy we’re entering Phase Two this week, you know? It’s a relief. I’m desperate for a haircut and I’m sure you are, too.
No, I didn’t mean to say that I thought you needed a haircut. Your hair looks great and the customer is always right.
Anyway, so I see you’re looking at those boots over there. What an excellent choice! You clearly have an eye for high fashion. I’m sure my daughter, who is on the other side of the plexiglass, wouldn’t mind taking them off and selling them to you.
Oh, you want new ones? Well, that may take a while because our shipment is in quarantine. Oh, no, wait, the shipment hasn’t even reached quarantine yet, so, ha ha, how about if you glance through the rest of the store while I pretend to read this dystopian book that I thought might be a good idea before we started to live in a dystopian society.
What’s that? Oh, well, I’ve had a few cups of coffee this morning because I thought I’d need to be my sharpest and this stupid book kept me up all night. But, hey, I’m like a phoenix, returning to the world of selling and socializing and connecting with my customers, because that, after all, is the key to being successful in business.
Wait, no, please, don’t leave. I know your child is outside screaming. You can bring her in. It’s fine, really. In fact, can I give you a hug? I was kidding. That was a test and you passed, so, yay for you.
Oh, I see you’re really going. Well, tell your friends about the store. Did I mention that your hair looks great?
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