In the last 24 hours, the number of hospitalizations declined by 97 to 1,441 people.
“That is by far the largest drop we’ve seen,” County Executive Steve Bellone (D) said on his daily conference call with reporters. “That is great news.”
Contributing to that net decline was the discharge of 124 patients from county hospitals.
The number of patients in the Intensive Care Unit also fell by 10 to 508, while the number of people on ventilators also declined.
At the same time, amid expanded testing in hotspot areas, the number of new positive tests increased by 783 to 27,485.
For the past two days, Suffolk County has not been able to report on the number of deaths associated with the pandemic. Today, Bellone said that an additional 132 people had died from coronavirus, bringing the total to 865.
The number of people who have died in connection with the virus is “staggering,” Bellone said.
Separately, over the past week, the county executive has been speaking with other officials in the county about trying to provide temporary property tax relief.
“We have to protect taxpayers in this county and we do that by providing relief and preventing long term damage,” Bellone said.
Bellone has been exploring whether Suffolk County might access some of the relief through the Cares Act that created a new entity called the Municipal Liquidity Facility.
This facility enables states and local governments to borrow money in the short term to address cash flow and the loss of revenue caused by the economic shutdown.
“This is exactly the kind of vehicle we need,” Bellone said.
The problem, however, is that the facility is only available to counties with a population of two million or more, which is above the 1.5 million people living in Suffolk County.
Bellone plans to send a letter to Treasury Secretary Steve Mnuchin, asking that guidance for that facility change so that counties the size of Suffolk can access municipal funding that would also provide relief to taxpayers.
From left, Kerstin Kleese van Dam, Brand Development Manager at BNL Diana Murphy, and John Hill at the Practical Quantum Computing Conference (Q2B) in San Jose, CA, Dec. 2019. Photo courtesy of Kerstin Kleese van Dam
By Daniel Dunaief
Brookhaven National Laboratory is putting its considerable human and technical resources behind the global effort to combat the coronavirus.
John Hill, the director of the National Synchrotron Lightsource II, is leading a working group to coordinate the lab’s COVID-19 science and technology initiatives. He is also working on a team to coordinate COVID-19 research across all the Department of Energy labs.
“We are proud that the tools we built at BNL, which include the NSLS II, which took 10 years to build and cost about a billion dollars,” will contribute to the public health effort, Hill said. “We feel that science will solve this problem, and hopefully soon. It’s great that BNL is a part of that fight.”
In addition to using high-technology equipment like the NSLS II to study the atomic structure of the virus and any possible treatments or vaccines, BNL is also engaging a team led by Kerstin Kleese van Dam, who is the director of BNL’s Computational Science Initiative.
According to Hill, the combination of the physical experiments and the computing expertise will provide a feedback loop that informs the efforts with each team. Kleese van Dam’s team is using supercomputers to run simulated experiments, matching up the atomic structure of the viral proteins with any potential drugs or small molecules that might interfere with its self-copying and life-destroying efforts.
The computer simulations will enable researchers to narrow down the list of potential drug candidates to a more manageable number. Experimental scientists can then test the most likelytreatments the computer helped select.
Across the world, the scale of the science to which BNL is contributing is even larger than the Manhattan Project that led to the creation of the atomic bomb during World War II, said Hill.
In just three months since scientists in China produced the genetic sequence of the coronavirus, researchers around the world have produced over 15,000 research articles, some of which have been published in scientific journals, while researchers have self-published others to share their findings in real time.
Working with computer scientists from different fields at BNL, Kleese van Dam is helping researchers screen through the abundant current research on COVID-19. The number of papers is “accelerating at a rate no one can read,” Hill explained.
Kleese van Dam and four of her scientists are setting up a natural language processing interface so scientists can type in what they want to find, such as a protein binding with a specific complex, and put it into a search engine. She is working on an initial service that she hopes to expand. Additionally, the computer science team is planning to start a project to look at epidemiological data to determine how various people might react to different treatment.
Kleese van Dam and her team are also working to build an archive in the United States that they hope will host at least the results of the Department of Energy funded projects in medical therapeutics. “[We are] convinced that this would provide a much better starting point for future outbreaks, as well as providing a near term clearing house of results,” she explained in an email.
As for the work at the synchrotron, Hill said that the high-energy x-rays can determine the specific atomic configuration of proteins in the virus.
The NSLS II, which was designed to study the structure of batteries, geology and plant cells, among other objects, can look at “small protein crystals better than anywhere else in the world.”
The virus relies on a docking mechanism that allows it to enter a cell and then insert its malevolent RNA to disrupt the cell’s normal function. Understanding how the pieces come together physically can allow researchers to look for small molecules or approved drugs that could interfere with the virus.
One of the many advantages of the synchrotron over protein crystallography is that the NSLS II doesn’t need as many copies of proteins to determine their atomic structure. Hill said protein crystallography needs samples that are about 100 to 200 microns in size, which is about the width of a human hair, which can take weeks to months to years to grow. This is a “bottleneck in the whole process” of solving protein structure, he said.
On the other hand, the NSLS II only requires samples of about a micron in size. This “greatly speeds up the process,” he added. Two different groups of researchers, from the pharmaceutical industry and from academia and national labs, are conducting experiments on the NSLS II.
Hill said he was receiving viral proteins scientists believe will bind with the virus from collaborators in the United Kingdom. The scientific process is as quick and collaborative as it’s ever been among researchers, he said. The proteins arrived recently.
That collaborative process would have “taken months to set up under normal circumstances,” Hill said. Instead, it only took a few days.
At the same time, BNL is constructing a cryo-electron microscope, which doesn’t have the same resolution as the NSLS II, but does not need crystals and can study individual proteins. Researchers need about 10,000 of them and can average the images together. The resolution is five to 10 times worse than x-rays.
BNL is accelerating the construction of the cryo EM and hope to have the first beam in mid-May. Commissioning will take some extra time, Hill said. The first structure of the coronavirus spike protein was determined by using an electron microscope.
For Hill and Kleese van Dam, who each have dedicated much of their time to these efforts, the opportunity to contribute to a project that could have implications for a public that is battling this disease is rewarding and offers reasons for optimism.
“To be able to help at such a scale is indeed humbling and gratifying,” said Kleese van Dam. “Science is going to solve this problem,” added Hill. “That gives me comfort.”
Until recently, many people thought COVID-19 was like the common cold or maybe like the flu. Now, most of us know somebody directly or indirectly who has been hospitalized with COVID-19.
While social distancing and handwashing are critical to prevent its spread, strengthening lung function is crucial to preventing its progression to severe disease.
Among those with highest risk for severe COVID-19 are those with chronic obstructive lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma, as well as those who smoke and vape.
What can we do to strengthen our lungs? We can improve lung function with simple lifestyle modifications including exercising, eating a plant-based diet with a focus on fruits and vegetables, expanding lung capacity with an incentive spirometer, and quitting smoking and vaping, which damage the lungs (1). Not only people with compromised lungs will benefit; studies suggest “healthy” people will also benefit.
Why is this important?
This virus starts in the throat but may progress to the lungs attacking the alveoli, small air sacs that allow gas exchange to take place. When this occurs, patients get short of breath and may have to be hospitalized and placed on a ventilator. Two factors influence this: inflammation and fluid in the lungs.
Both asthma and COPD increase inflammation of the airways and the lung’s functional tissue (parenchyma) thus, potentially making these patients more susceptible to severe COVID-19.
Let’s look at the research, taking a three-pronged, or “forked,” approach: diet, incentive spirometry and exercise.
Diet Studies in Asthma
In a randomized controlled trial (gold standard of studies) of asthma patients, results show that after 14 days those who ate a low-antioxidant diet had less lung function compared to those who ate a high-antioxidant diet (2). Researchers measured lung function with one-second forced expiratory volume (FEV1) and predicted forced vital capacity (FVC). Additionally, those who were in the low-antioxidant diet group also had higher inflammation at 14 weeks, as measured using a c-reactive protein (CRP) biomarker. Those who were in the low-antioxidant group also were over two-times more likely to have an asthma exacerbation.
The good news is that the difference in behavior between the high- and low-antioxidant groups was small. The high-antioxidant group had a modest five servings of vegetables and two servings of fruit daily, while the low-antioxidant group ate no more than two servings of vegetables and one serving of fruit daily. Carotenoid supplementation, instead of antioxidant foods, made no difference in inflammation. The authors concluded that an increase in carotenoids from diet have a clinically significant impact on asthma and can be seen in a very short period.
Diet Studies in COPD
Several studies demonstrate that higher consumption of fiber from plants decreases the risk of COPD in smokers and ex-smokers. Bear with me, because the studies were done with men or women, not both at the same time. In one study of men, for example, results showed that higher fiber intake was associated with significant 48 percent reductions in COPD incidence in smokers and 38 percent incidence reductions in ex-smokers (3). The high-fiber group ate at least 36.8 grams per day, compared to the low-fiber group, which ate less than 23.7 grams per day. Fiber sources were fruits, vegetables and whole grain, essentially a whole foods plant-based diet. The high-fiber group was still below the American Dietetic Association-recommended 38 grams per day. This is within our grasp.
In another study, women had a highly significant 37 percent decreased risk of COPD among those who consumed at least 2.5 serving of fruit per day compared to those who consumed less than 0.8 servings per day (4).
The highlighted fruits shown to reduce COPD in both men and women included apples, bananas, and pears.
Incentive Spirometry
What is an incentive spirometer? It’s a device that helps expand the lungs by inhaling through a tube and causing a ball or multiple balls to rise. This opens the alveoli and may help you breathe better.
Incentive spirometry has been used for patients with pneumonia, those who have chest or abdominal surgery and those with asthma or COPD, but it has also been useful for healthy participants (5).
A small study showed that those who trained with an incentive spirometer for two weeks increased their vital capacity, right and left chest wall motion, and right diaphragm motion. This means it improved lung function and respiratory motion. Participants were 10 non-smoking healthy adults who were instructed to take five sets of five deep breaths twice a day, totaling 50 deep breaths per day. The brands used in the study are easily accessible, such as Teleflex’s Triflo II.
In another small, two-month study of 27 patients with COPD, the incentive spirometer improved blood gasses, such as partial pressure carbon dioxide and oxygen, in COPD patients with exacerbation (6). The authors concluded that it may improve quality of life for COPD patients.
Exercise Studies
Photo from METRO
Exercise can have a direct impact on lung function. In a study involving healthy women ages 65 years and older, results showed that 20 minutes of high-intensity exercise three times a day improved FEV1 and FVC, both indicators of lung function, in as little as 12 weeks (7). Participants began with a 15-minute warm-up, then 20 minutes of high-intensity exercise on a treadmill, followed by 15 minutes of cool-down with stretching.
What is impressive is that it was done in older adults, not those in their twenties and not in elite athletes. Since most of us don’t have access to a treadmill right now, note that any physical exercise will be beneficial.
We should be working to strengthen our lungs, regardless of COVID-19. However, to potentially reduce our risk of severe COVID-19, this three-pronged approach of lifestyle modifications – diet, exercise and incentive spirometer – may help without expending significant time or expense. As Yogi Berra would say, “When you come to a fork in the road, take it!” There is no time to waste.
References:
(1) Public Health Rep. 2011 Mar-Apr; 126(2): 158-159. (2) Am J Clin Nutr. 2012 Sep;96(3):534-43. (3) Epidemiology Mar 2018;29(2):254-260. (4) Int J Epidemiol Dec 1 2018;47(6);1897-1909. (5) Ann Rehabil Med. Jun 2015;39(3):360-365. (6) Respirology. Jun 2005;10(3):349-53. (7) J Phys Ther Sci. Aug 2017;29(8):1454-1457.
Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
Jennifer McGuigan's five children work on their schoolwork at home. Photo by McGuigan
By Deniz Yildirm
With the arrival of the Coronavirus, New Yorkers have been forced to practice social distancing and with that, so called distance learning. Distance learning is a relatively new phrase which means a method of studying in which lectures are broadcast and classes are conducted over the internet. And while many teachers at Comsewogue are familiar with online tools, there is still a steep learning curve.
Don Heberer, the District Administrator for Instructional Technology and Frank Franzese, the district’s Educational Technology Specialist teacher have been working tirelessly to help teachers and students shift to distance learning.
“Everyone is putting in long hours” Franzese said. “There’s no such thing as a one way email. Every teacher is trying to give their classes a first rate education using technology, even when it’s stressing them out. So I’m going to do everything I can to help.”
Despite the speed of setting up this distance learning, the quality of work is really outstanding. “I’m so impressed with the level of collaboration and dedication my teachers have to making this work and connecting with students.” said Terryville elementary Principal Annemarie Sciove, who has has two young children and said she understands how important it is for children to feel connections with their teachers and the challenges of working from home. Despite this challenge, third-grade teachers Mrs. Sciarrino and Ms. Benson are working together to create some of the most comprehensive google classrooms for their students. So far they’ve uploaded countless resources and worksheets even though it’s their first time using google classroom. Sites like xtramath.org, storyonline.net and classroom.magazine.com are just a few of the websites they’ve shared with students to help them continue to grow at home. And even though spring break has been cancelled, these teachers have found a way to make this week extra special by planning a “virtual vacation.” Students will “visit” special places via youtube and google earth then report back to their teachers.
“It’s a great learning experience and a warm up to our country report project in May,” Sciarrino said.
Teachers have also been uploading videos of themselves, including teachers Mrs. Dunn and Mrs. Zoccoli who have created videos for their classes where they are offering support and encouragement.
Physical education teacher Mr. Chesterton posted a video challenging his students to a jumping jack countoff (he got up to 50 while one student reported 100). This kind of teaching is really meaningful to the kids who are stressed out and missing school.
Just ask Jennifer McGuigan, like so many parents she is facing the challenge of supporting her five children (the oldest John in college, 11th-grader Joe, ninth-grader Lydia, seventh-grader William and fifth-grader Lila.
“I want them to know it’s okay and it’s easier to do that with the support of the teachers,” McGuigan said. “It can be a lot sometimes, every one of them has at least five classes they have to check in to but it’s a welcome distraction.”
She also says it’s helpful to establish a schedule and reiterate that no one is looking for perfection, teachers are just looking for students to do their best.
Superintendent Dr. Quinn couldn’t agree more, as she’s recently said in her call home, “We’re in this together.”
Deniz Yildirim is a librarian at the Terryville Road Elementary School. For students, she has posted a video showing how they can make a temporary library card so they can borrow ebooks.
Nursing homes have become a hotbed of discussion over the large percentage of their residents who have died from COVID-19 while in New York facilities. Stock photo
Slowly, the numbers in the fight against the coronavirus are moving in a favorable direction.
For the fourth time in six days, the number of hospitalizations in Suffolk County dropped. Residents in hospitals in the county declined by 23 to 1,562. The number of people in the Intensive Care Unit also declined by 16 to 521, while the number of people who are on ventilators also fell by 14 to 445.
“We hope those numbers will continue to go down,” County Executive Steve Bellone (D) said on his daily conference call with reporters.
In another positive sign, the number of people discharged from hospitals increased by 122, bringing the total number of people discharged from the hospital due to coronavirus infections to 2,134.
The county continued to provide personal protective equipment to first responders and health care workers. Yesterday, the county handed out 81,000 piece of personal protective equipment to fire, EMS, hospital and nursing homes. The county will hand out another round today.
Suffolk is also delivering additional masks to grocery stores and supermarkets to give to essential employees in order to protect themselves and their customers.
The county purchased 27,000 gowns that are expected to arrive tomorrow. Those gowns came from a domestic provider. Next week, the county is expecting a much larger shipment of 500,000 gowns, which the county bought from an overseas provider.
The gowns should “provide more breathing space for us,” Bellone said.
Bellone said he appreciated the ongoing quick and effective action of emergency services personnel. Several fire departments put out a brush fire in Manorville near Brookhaven National Laboratory, which started yesterday around 12:30 pm.
“Our fire departments and emergency agencies responded to the scene and they did an outstanding job in putting that out,” Bellone said. “Even in a global pandemic, [these emergency crews] are responding every day.”
Responding to questions about whether Long Island beaches and summer facilities would be open this summer, Bellone deferred any such decision until a later date.
“The amount that we have seen change in our understanding of what’s happening and the response and what works and what doesn’t is “dramatic” since the start of social distancing and New York Pause, Bellone said. “We need to tay the course. It appears we are plateauing. We are hopeful we will see the trajectory of the numbers going down.”
Separately, the number of Suffolk County Police officers who have tested positive for coronavirus is 81, with 49 returning to work.
As of Wednesday, the number of times the police have checked on people who might not have been following social distancing guidelines was 618, with 55 who were not in compliance. The police have not issued any summonses during these checks.
We need help, and we need it fast. Not just for COVID-19, but also for diabetes, for the combination of the two is much worse than either disease alone. Type 2 diabetes can have devastating effects that can potentially result in patients dying prematurely from cardiovascular complications (1). COVID-19 symptoms can range from asymptomatic to severe or result in death.
Now combine diabetes with COVID-19 and you are at much higher risk of severe viral symptoms that require hospitalization and ICU admission. According to the CDC, about one-third ICU patients infected with COVID-19 have diabetes (2).
Keeping patients out of the hospital
We know containment is critical to control COVID-19, but it’s equally important to get ahead of the mitigation of symptoms curve; we need to control the chronic diseases that exacerbate the virus’s severity. And Type 2 diabetes is one of the largest contributors.
We can treat and reverse diabetes by empowering patients with lifestyle changes, especially diet. This is such an issue that the Mexican Deputy Minister of Health recently alluded to the fact that poor diet over at least the last 4 decades has resulted in more diabetes and obesity making people much more susceptible to COVID-19 and progressing to severe COVID-19 (3).
It is tempting while staying at home for most of the day to want reach for comfort foods. Don’t do it. In fact, take the opposite approach and improve your diet. A whole food plant-based (WFPB) diet has been shown time and time again to prevent, treat and reverse diabetes potentially resulting in patients getting off their drugs and achieving levels that are considered normoglycemic, or non-diabetic.
Let’s look at the evidence.
Treating and reversing diabetes
Drugs help treat glucose, or sugar levels, and help reduce the risk of microvascular diseases such as diabetic retinopathy (eye disease causing blindness); nephropathy (kidney disease); and peripheral neuropathy, which can result in amputation. A few medications can even reduce macrovascular risk, or cardiovascular disease. Still, diet is still the best tool we have for reversing diabetes overall, with only beneficial side effects.
With COVID-19, those whose glucose is not under control are at highest risk of severe disease that results in a progression from hospitalization to ICU and the need for a ventilator to increased mortality risk. High sugars may have negative impacts on the white blood cells, which makes patients more susceptible to infection from viruses (4).
Medications’ impact
Diabetes medication alone can help control sugars, but it can’t reverse diabetes. In fact, studies with medication alone may actually increase the risk of death from polypharmacy, or too many medications. In the ACCORD trial, patients were put on an average of four diabetes medications. Researchers stopped the trial early after 3.5 years, because of a 22 percent increased rate of mortality (5). Patients did not reach their HbA1C (a three-month sugar reading) target of under 6.0 percent, because the increased death rate occurred at around 6.5. This was a large randomized controlled clinical trial with 10,251 patients, a mean age of 62.2 years, and mean HbA1C of 8.1 at baseline.
Reversing Type 2 diabetes:plant-based dietary approach
On the other hand, studies with a WFPB diet, have shown significant reduction in sugars and potential reversal of diabetes. These include a small retrospective study and small randomized clinical trial comparing a WFPB diet to the American Diabetes’ (ADA) recommended diet.
In a small retrospective study, the results showed a reduction of HbA1C from 8.2, which was a similar baseline as with the ACCORD trial, to 5.8 (6). Remember, the goal of the ACCORD trial was to get patients below a HbA1C of 6.0. These results occurred over a mean of seven months. In addition, patients were able to stop all of their diabetes medications and reduce their total number of medications from four to one.The side effect was better health with a significant reduction in high blood pressure to normal levels, as well.
The weakness of this study was that it was retrospective (looking backward in time), only had 13 patients, and there was no control arm. However, it suggests that this type of diet is powerful to reduce and reverse type 2 diabetes. The foods used in the nutrient-dense WFPB diet included a non-starchy vegetable-rich approach, with an emphasis on dark green leafy vegetables, whole fruits, beans, and limiting grains, especially refined grains, and limiting starchy vegetables such as sweet potatoes, winter squashes, corn and pumpkin.
In a larger study, results showed that a high fiber diet in patients with type 2 diabetes and hypertension significantly reduced HbA1C, fasting glucose, systolic (top number) blood pressure, branchial-ankle pulse wave velocity, serum cholesterol and waist-to-hip ratio, ultimately reducing the risk of cardiovascular disease (7). The participants were considered to be having high fiber if they increased their consumption 20-25 percent above recommended daily allowances. The fiber came from foods, not supplements, including vegetables, fruits, beans and whole grains. There were 200 participants over a six-month duration.
A third study, which was a randomized controlled trial comparing the 2003 American Diabetes Association (ADA) diet to a low-fat vegan diet showed that a low-fat vegan diet significantly reduced the HbA1C compared to the 2003 ADA diet in a 74-week study (8). There were 99 type 2 diabetes patients in the study. A “side effect” of the low-fat vegan diet was that it also significantly reduced cholesterol.
Preventing diabetes
There have been numerous studies demonstrating that a WFPB diet reduces the risk of diabetes. One of the best was the Adventist Health Study 2 (9). The results showed that a vegan diet reduced the risk of type 2 diabetes by 49 percent. This study is interesting because the different groups were very similar and it showed that small changes could have a big impact. Semi-vegetarians, pesco-vegetarians, and lacto-ovo vegetarians all had a reduced risk of diabetes compared to plant-focused non-vegetarians, but not as much as vegans.
In a more recent study, results showed a 30 percent reduction in the risk of type 2 diabetes for those who ate a predominantly whole food plant-based diet including fruits, vegetables and whole grains (10). Participants were still eating some animal protein daily. This was over a 2-to-28 year period in a metanalysis involving nine observational trials.
In conclusion, the best way to reduce your risk of severe COVID-19 is to control and reverse chronic disease. Type 2 diabetes is one of the most common chronic diseases that may contribute to getting COVID-19 and progressing to a severe form. A nutrient-dense WFPB diet has been shown to potentially reverse type 2 diabetes. While you are mostly housebound, empower yourself by taking action to reduce your risk of getting COVID-19 and especially the severe disease. We have the tools: it starts with what you put on your plate.
References:
(1) Lancet 389(10085):2239–2251. (2) CDC.gov. (3) Reuters.com April 4, 2020. (4) Medscape.com March 18, 2020. (5) NEJM 2008;358:2545-2559. (6) OJPM 2012;2(3):364-371. (7) ACC Middle East Conference 2019 Presentation. (8) Am J Clin Nutr.2009 May; 89(5): 1588S–1596S. (9) Diabetes Care. 2009;32:791–796. (10) JAMA Int. Med. Online July 22, 2019.
Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
U.S. Sen. Chuck Schumer said there is need to increase the PPP loan funding, but he and Republicans have disagreed how. File photo by Kevin Redding
The federal Small Business Administration announced the government’s Payment Protection Program, which initially put up $349 billion in funds for small businesses across the country, has run out of funding in just eight days since it came online.
Thousands of loans are still being processed, and both government and small business owners are calling for more funds to be added to the bill, which was meant to stimulate small businesses and help keep more from filing for unemployment.
Around 41,000 loans have been approved for New York State out of 1.7 million. However, many businesses were left short of approval or didn’t manage to file in time. Others, who filed early as possible, found their early attempts confused with both misinformation and lack of clarity from banks and federal agencies.
Bernie Ryba, the regional director of the Stony Brook Small Business Development Center , said during a live stream with the Rocky Point Sound Beach Chamber of Commerce April 16 there are growing signs of the economy deteriorating “faster than anticipated,” and the $2.2 trillion CARES Act, passed at the end of March, may not be enough.
He added banks have already been ordered to not accept any more applications.
“It demonstrates the extent of the damage small businesses have experienced over the past three weeks,” he said.
Ryba said the SBA was not staffed to handle the number of applications. From acceptance of application to approval was going to be 30 days, but he said that number has gone out the window due to the incredible number of applications.
Some have also criticized who have been able to apply for loans, and how quickly they received it. Politico reported that a number of large chain restaurants ate up millions of dollars in loans meant for small businesses. Such chains as the companies behind Potbelly Sandwich Shop and Ruth’s Chris Steak House, each received $20 million and $10 million in loans respectively. While the loans were meant for companies with 500 or less employees, this rule was expanded to allow companies to apply as long as they didn’t have more than 500 employees in a single location.
While both Republicans and Democrats agree more funds need to be added, the parties are bickering back and forth about how much. The GOP has proposed an additional $250 billion to the PPP program, but Dems stymied that, arguing the bill, which U.S. Sen. Chuck Schumer (D) called CARE 3.5, should also include $100 billion for hospitals, $150 billion for state and local governments and a boost to food assistance. Republicans have blocked that effort in return.
Schumer, the senate minority leader, said in a live streamed conference with Long Island Association President and CEO Kevin Law April 17 that there could be two additional COVID-related bills in the near future.
Meanwhile, Ryba said his small business center, which also has offices in SUNY Farmingdale, will be receiving around $1.1 million in federal assistance so they can hire additional staff in order to handle a larger number of business owners looking for advice.
Law said the thing of biggest importance isn’t the long term of the whole U.S. economy, but making sure that these small businesses and average people have money in their pockets to deal with the short term. He also questioned whether the government may allow some different types of nonprofits to apply for aid through PPP, as currently only 501c3’s are applicable. Schumer said they would look into allowing 501c6’s and others to also apply for any further aid in the future.
Schumer agreed, saying the government’s focus should be twofold, adding the government needs to approve the PPP extension “so their money gets out there faster, it is job number one. Testing — if we don’t get it done we’re not going to recover. Those are the two biggest things.”
More from Schumer and Law’s Conversation
People are facing multiple hurdles during the ongoing coronavirus crisis, but Law said those people need help from the federal government.
With people’s $1,200 checks for people making under $75,000 a year finally going out, Schumer said that should not be the end of such funds to everyday Americans. He added he thought the wage limit should be raised to people making around $99,000 a year.
“If you have a wife who is a hospital worker, you’re making more than [the $75K] but you still need help,” he said.
In terms of mortgages, Law said while there was something being done for those with federally backed mortgages, he asked if there was anything being done for those with more locally or commercially backed mortgages.
“We need some kind of commercial forbearance for both commercial and tenants,” Schumer said. “I pushed for this in CARE 3.” (The bill called the CARES Act passed March 30.)
The LIRR is currently asking for an additional bailout, with ridership now down by 97 percent, but services are continuing for essential workers, especially those working in health care. Schumer said he wants to provide more assistance to both the LIRR and to the Suffolk and Nassau bus systems.
For other municipalities, he said bills he called CARE 4 and 5, the first of which he expected to come up in the first few weeks of May, will also include more money for townships who have also experienced revenue shortfalls from the coronavirus.
Law also suggested the federal government look into creating some kind of public works program in the vein of President Franklin Roosevelt’s post-Great Depression programs in the 1930s and 40s, specifically for public and infrastructure works such as roads, bridges and sewers. Schumer agreed with the idea for when things finally start to open up.
“We’re going to have to stimulate the economy, and the best way to do that is through infrastructure,” the senator said.
Stony Brook's Mobile Stroke Unit is continuing operations despite the ongoing coronavirus pandemic. Photo from SBUH
Amid the start of new coronavirus testing at hotspots including Wyandanch and North Amityville today, the number of residents testing positive for the virus that causes COVID-19 increased by 960 in the last 24 hours to 24,483.
At the same time, hospitalizations have declined by 45 patients to 1,585.
“That is the key number we have been watching,” Suffolk County Executive Steve Bellone (D) said on his daily conference call with reporters.
The number of people in the Intensive Care Unit also fell by 25 to 537, while the number of people intubated also declined.
The drop in hospitalizations marks the third time in five days that the closely watched gauge has declined, while the increases in the previous two days were smaller than the weekly average in the prior week.
Bellone suggested that these numbers could suggest a “leveling off,” albeit at a high level.
Suffolk County continues to add hospital beds, increasing capacity by 39 to 3,425, with 744 ICU beds.
The number of beds available is now 655 overall, with 112 ICU beds.
The “good news,” Bellone said, is that 152 people were discharged from the hospital in the last day.
At the same time, the county continues to suffer losses stemming from the virus. In the last 24 hours, 40 people have died, bringing the number of deaths to 693.
Earlier today, Gov. Andrew Cuomo (D) extended New York Pause to May 15, which means that schools and non-essential businesses will remain shut through at least that period. Starting tomorrow, residents of New York will be required to wear face masks when they are in public places and they can’t maintain social distancing of at least six feet.
Bellone mentioned several initiatives the county has started to manage the economic and employment recovery.
He described the potential need to change the Suffolk County Tax Act, which is a law that’s been on the books for 100 years that blocks the county’s ability to access tax funds until the middle of the year.
“Because of that, the county has to borrow money to get through the first six months of the year,” Bellone said.
Bellone announced that the county has created a COVID-19 Fiscal Impact Panel, which will analyze the ways the virus is causing damage to the county’s finances. Emily Youssouf, who Bellone described as an “expert in private and public sector finance,” will chair that panel. Youssouf had been a board member for the New York City Housing Authority under the Bloomberg Administration.
Stony Brook Announcements
Stony Brook University said it will continue to operate its two Mobile Stroke Units. The specialized ambulances are available every day from 8 a.m. to 8 p.m. The units allow patient triage and treatment in the field. Clinicians aboard the ambulances can administer a medication that minimizes brain injury at any location and then, when necessary, can transport the patient to the closest facility.
With a stroke, time is critical to save brain cells, explained Dr. David Fiorella, Director of the Stony Brook Cerebrovascular Center and founder of the mobile stroke centers.
Separately, Stony Brook University Hospital recognizes the anxiety patients feel when each health care professional who comes into their rooms is wearing a mask and, often, a face shield that hides most of their face. In one unit of the hospital, care givers will begin wearing staff ID pictures on their gowns so patients can see the face of the staff member providing care. The idea may extend to other areas of the hospital after a pilot period.
The idea, called the Face Behind the Mask, came from Nurse Practitioner April Plank after she started working in a COVID unit
All businesses with under 500 employees can apply for the federal loan to rehire employees, but some have experienced issues. Stock photo
Businesses are looking for sanctuary during the absolute tumult caused by the ongoing coronavirus pandemic. However, some say even with the federal government’s attempt to help keep employees on payroll and businesses running, some question when their submissions will be processed, while others question how much it would help.
The $349 billion Paycheck Protection Program, which passed congress in March as part of the $2 trillion CARES Act relief bill, was made to offer businesses with 500 employees or less loans up to $10 million specifically to keep on or rehire employees. This is partly to keep those shops afloat while revenues have plummeted and to keep people from being forced to go on unemployment. New York’s unemployment system, in particular, has been overwhelmed, with over 600,000 claims processes and another 200,000 still in partial status. Many people report having to call the unemployment offices dozens or even 100s of times and not getting a response.
“How can you expect us to bring employees back full force if you’re not allowing us to open the doors?”
— James Luciano
But as Gov. Andrew Cuomo (D) and other states are starting to meet to discuss a timeline for bringing everything back online, businesses still await the loans that will essentially enable them to rehire those employees.
For others, the loans may be too late. Bernie Ryba, the director of the Stony Brook Small Business Development Center, said by the center’s estimates there could be as many as 25 percent of restaurants across the country saying they have likely closed permanently. Another 25 percent, he said, could be also looking at shutting their doors.
“If you have, in the restaurant industry, 12 million that are employed, you’re looking at 6 million that will never go back to work,” he said.
That’s why applying for the PPP loans early is so important, not to mention that the money could eventually run out, though congress is in talks of supplementing the program with additional funds.
The PPP loans of up to $10 million would normally have to be paid off with a 1 percent interest rate over two years, but if 75 percent of funds are used for payroll, keeping staff to pre-pandemic levels for eight weeks after the loan is disbursed, then the loans will be forgiven.
Ryba said it is incredibly important for businesses to apply as soon as possible, adding there have been some businesses who reported to him receiving funds already. However, for businesses who have applied and haven’t heard anything back about their applications, some owners are left with a bad taste in their mouths.
Several have complained the rules of the loan were not well explained, and the timeline for when money can and will be disbursed is hanging in the air, all the while business owners can only sit around in the anxiety of not knowing.
Roger Rutherford, the general manager of Roger’s Frigate in Port Jeff and the president of the PJ Business Improvement District, related it to the disaster loans after Hurricane Sandy in 2012, when he said it took him two years and multiple meetings before he ever saw a dime from the federal government. Though he said the timeline for these loans should be much shorter than that disaster, he said his daily calls have not yet resulted in word on the loan.
James Luciano, the owner of the Port Jeff Lobster House and BID secretary, said he, along with most business owners he knows, have applied for the PPP loan. However, he said it could be weeks before he even hears his application was processed, and the guidelines were not clear on what he would get or have to repay.
“They’re keeping up this thing to bring employees back, but how can you expect us to bring employees back full force if you’re not allowing us to open the doors?” he said.
The government has clarified that employees would have to be rehired to levels as of Feb. 15 by June 30.
Such need for clarifications has been constant from the federal government. Problems with the program started on day one, according to the Wall Street Journal which wrote that the nation’s largest banks were unable to take loan applications when it launched April 3 because the government did not send them application documentation until the previous night. Ryba said the institution of the program “took lenders by surprise,” with many having only one week to prepare top accept applicants.
Some businesses have also had issues applying for the loan, especially if they were affiliated with smaller community banks that are not certified with the federal Small Business Administration as an approved lender. Other larger regional and national banks, Ryba said, have focused more on their own customers who do business with them, not even those who may only use the bank to deposit.
“This is very different from 2008 — now you see banks and borrowers working together.”
— Charlie Lefkowitz
In such cases, applying for the loan requires different documentation.
The PPP is just one of several loan systems businesses have been applying to in this time of crisis. The Economic Injury Disaster Loan Emergency Advance is supposed to loan businesses up to $10,000 in economic relief. The loan wouldn’t have to be repaid, though. Nationally, businesses have told outlets like The New York Times that such funding has all but dried up.
Luciano said he has received an email saying his PPP loan was approved and to expect paperwork in the next five business days. However, he added he has heard nothing about his disaster loan application, and his accountant told him he “did not expect anyone to see that money.”
In a conference call with businesses March 26, before the final bill was signed, U.S. Rep. Lee Zeldin (R-NY1) held a conference call with local businesses along with the Long Island branch manager of the Small Business Administration Robert Piechota. Piechota said at the time while the bill had yet to be signed, in normal times such loans would take around 21 days for the application to be processed, and another five for the money to be released.
“In good times you’re looking at a month,” he said.
Jennifer Dzvonar, the owner of Bass Electric in Port Jefferson Station and president of the Port Jefferson Station/Terryville Chamber of Commerce, said there is much misinformation out there on the internet, and the best choice for anyone looking to get the loan is to go to the SBA website.
Despite not yet hearing of a single business that has yet received any funds from the loans, Charlie Lefkowitz, the president of the Three Village Chamber of Commerce, said there has been a general effort on all levels, whether its regional government down to the community level, to help these businesses in their time of need.
“This is very different from 2008 — now you see banks and borrowers working together,” he said. “This is unprecedented, and across our community … you’re seeing cooperation on all levels.”
Terryville EMS members, including, from left, Lauren Maloney, Andrew Hoyt, Tom Fauteux, Daniel Ortiz, Jacob Parrish and Gina Brett. Photo by Kyle Barr
If we are to keep using war terms to describe the ongoing coronavirus pandemic, calling nurses and doctors “soldiers” who are “on the front lines,” whose personal protective equipment are like “tools” or “weapons” in the fight against COVID-19, then the Emergency Medical service members, whether paid or volunteer, truly are the ones who make first contact with the enemy.
Joe DiBernardo, President of the Lieutenant Joseph P. DiBernardo Memorial Foundation, donates masks to Kyle Matura of the Miller Place FD. Photo from DiBernardo
Though members of local EMS services said they don’t know exactly how to feel about that terminology. If anything, it’s the unknown of every situation that makes the whole thought stick.
“Every patient is a risk,” said Daniel Ortiz, an EMS member of the Terryville Fire Department. “That’s where I guess they say it’s a war zone, because you don’t know what you’re walking into.”
EMS members from all over the North Shore have experienced a heavy time of stress during the ongoing coronavirus pandemic, though as the number of cases seems to have plateaued as New York enters the middle of April, these service members, both paid and volunteer, are still asking people to continue their social distancing, as we’re not out of the woods yet.
The emergency service members said they have been wearing much more gear than normal, including masks, head coverings, face shields and eye protection. Every single call they go on is in this gear, since every case is now treated like a COVID-19 situation, despite what might have been said by the caller on the phone.
“We trained for this, and I can honestly say this is the first time in 10 years that I’ve seen anybody suit up other than your annual refresher,” said Terryville member of the EMS squad Andrew Hoyt.
While the Terryville Fire District only covers about eight square miles, the Commack Volunteer Ambulance Corps. covers nearly 15 square miles, dipping into both the Huntington and Smithtown townships.
Joseph Vollers, the 3rd assistant chief of the Commack corps., said they have been helping neighboring districts with their call volumes, including Brentwood, which has been a particularly large hotspot for coronavirus cases. With that, they have gone from one to two full crews with a driver and EMT available at all times. Terryville has effectively done the same, moving from one to two ambulances available.
“It’s a pretty big area we have to cover,” Vollers said.
Other fire districts increased the load and numbers of EMTs and paramedics on a shift. The extra hard part has been decontamination, as now after every call both the people on the truck and the truck itself have to be cleaned from top to bottom.
If the job was stressful before, the understanding that one might be potentially taking the virus home with them after each stress only adds to the level of concern. Most agreed they had never seen anything at this scale. While EMS members knew they had to be aware of contractible diseases, such as tuberculosis, flu, scabies or even bed bugs, the pandemic levels of how far the virus has spread, every single person is approached as if they have SARS-CoV-2.
David Sterne, the Setauket Fire District Manager, said there were five cases of COVID-19 in the department, with more staying home with suspected cases. Though as of now, four of those cases have returned to work. In Terryville, they’ve had two cases out of the 15 paid paramedic staff and 25 volunteer EMTs.
“It’s stressful for a lot of reasons,” Sterne said. “We’re in their environment where there could be infectious viral loads. If a patient is sick, it could be 10 or 15 minutes to take them to the hospital … everyone fears bringing it home to their families and loved ones.”
Sterne added the district has had to make do with a lack of certain items, such as the coveted N95 masks for their medical personnel. New policy has been these masks, which are normally only supposed to be used once and then thrown away, have been used multiple times. Setauket FD had been concerned at several points with limited supplies, but with support from Suffolk County, Sterne said they are now in a relatively good spot.
But support for the fire departments are coming from all corners and some unexpected places. On Wednesday, April 15, retired FDNY Deputy Chief Joe DiBernardo, who is president of the Joseph P. DiBernardo Memorial Foundation, worked with y Fire Hooks Unlimited, a company that manufactures tools and supplies for firefighters and police, to deliver 100 N95 masks to the Miller Place Fire Department and 200 to the Setauket Fire Department.
Joe DiBernardo, president of the Lieutenant Joseph P. DiBernardo Memorial Foundation, center, donates masks to the Setauket Fire Department. Photo from DiBernardo
The memorial foundation is for DiBernardo’s son, Joe DiBernardo, who was injured in the line of duty during a tenement fire in 2005. He died as a result from his injuries in 2011. The foundation works to train and equip firefighters in need.
Now the districts have settled into the routine and have seen a small improvement in the number of calls from mid-to-late March, where the number of coronavirus deaths started to rise with startling speed.
With suspected coronavirus patients, it wasn’t so much the usual dealing with people having injuries or back and abdominal pains, it was instead situations where a person might desperately need oxygen. While the numbers of people with heart attacks and other sudden traumas have stayed the same, EMT staff said people calling for respiratory issues tripled in the month of March.
Other, more usual calls of non-life threatening injuries dropped off significantly. EMTs said this was largely because people did not want to go to the hospital where the possibility of viral infection was that much higher.
“I think there’s people afraid to go to the hospital,” said Gina Brett, the Terryville EMS coordinator. “They say, ‘I don’t want to go to the hospital for knee pain, because I might get very sick at the hospital.’”
District officials said that despite the load, they’ve managed.
“Overall it hasn’t been exceedingly stressful where we can’t function,” Vollers said. “Our crews have been amazing at overcoming all stresses, with 2, 3, 4 calls back-to-back, they’ve done a great job.”
Despite the stress, the service members agreed their communities have been excellent in their care and even compassion. The Commack Fire Department, for example, recently held a drive where community members donated over 500 items, both nonperishable food and medical supplies.
Otherwise, EMTs said the best thing for people to do is continue social distancing to help flatten the curve. Another suggestion is after calling 911, people should meet the EMTs and paramedics outside the home in order to best reduce first responders’ interaction with anything that may be contaminated.
“It is an incredibly long time to have that level of awareness and vigilance,” said paramedic Dr. Lauren Moloney, an associate medical director for the Stony Brook University paramedic program. “God knows how long it’s going to go on for. That’s the hardest thing — trying to find what is your date you’re trying to get through.”
This article was amended April 16 to amend the nature of Fire Hooks Unlimited’s operations.
This article was amended April 17 to correct the name of the Commack volunteer ambulance corps.
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