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Covid 19

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By Daniel Dunaief

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The number of people battling significant symptoms from the flu and respiratory syncytial virus has been coming down since its peak in January, as these infections have run their course.

“This year, we experienced the most severe flu and RSV waves in decades, and our COVID wave wasn’t small either,” said Sean Clouston, associate professor of Public Health at Stony Brook University.

The number of these illnesses was high as people no longer wore masks in places like schools and after people experienced lower-than-usual illnesses in the months before the mask mandate was lifted, creating fertile ground for viruses to spread.

“The most likely reason that the current flu and RSV seasons have improved is that we have had such a bad season earlier on that we have hit a natural ceiling on the ability for these diseases to successfully infect more people,” Clouston said in an email.

As for COVID-19, the numbers of people who have developed significant illnesses has continued to decline as well, through a combination of the natural immunity people have after their bodies successfully fought off the infection and from the protection offered by the vaccine and boosters.

Doctors added that the vaccine and natural immunity hasn’t prevented people from getting infected, but they have helped people avoid severe and potentially life-threatening symptoms.

“All these people who run around saying, ‘My vaccine isn’t working because I got reinfected,’ are missing the point,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases at Stony Brook Medicine. “It is working. It doesn’t protect you from infection, but [it does prevent] a bad outcome.”

Indeed, during the most recent COVID surge during the winter, Fries said the hospital continued to care for patients, most of whom recovered. 

Vaccine timing

Amid discussions from the Centers for Disease Control and Prevention and health organizations throughout the state and country about the timing of future booster shots, local health care providers indicated the increasing likelihood of an annual COVID booster.

Fries said we will get to an annual vaccination for COVID, adding, “It’s the same as we see with the flu.”

In general, people aren’t rushing off to get an updated COVID booster.

“To maximize the protective value of the vaccine while minimizing the number of vaccines you use, people should likely get the vaccine two weeks before they anticipate heavy exposure,” Clouston said.

For most people, that would mean getting the shot in early November to prepare for larger indoor gatherings, like Thanksgiving and the December holidays.

In a recent article in the journal Lancet, researchers conducted an extensive analysis of COVID reinfection rates.

The study dealt only with those people who had not had any vaccinations and addressed the effectiveness of natural immunity from preventing infections and from the worst symptoms of the disease.

Prior infections in general didn’t prevent people from getting reinfected, but it does “protect you from getting a really bad disease and dying,” Fries said.

Long COVID

Even with the number of people contracting COVID declining, the overall population of people battling symptoms of long COVID, which can still include anything from loss of smell and taste to chronic fatigue, continues to increase.

“There’s a plethora of symptoms of long COVID,” Fries said. “We’ll have to figure out how to classify this and hopefully come up with better therapy. Right now, we can only symptomatically treat these patients.”

Dr. Sritha Rajupet, director of the Stony Brook Medicine Post-COVID Clinic, explained in an email that some patients who have lost their sense of smell or have a distorted sense of taste have tried a process called a stellate ganglion block “after several case reports and early research have shown that it could be helpful.”

In such a procedure, doctors inject a local anesthetic on either side of the voice box into the neck. Rajupet said that “additional research and clinical trials still have to be performed.”

Newborns and COVID

As for children infected with COVID soon after birth, doctors suggested that the impact has been manageable.

“The great majority of young children who contract COVID do quite well and recover fully,” Dr. Susan Walker, pediatrician with Stony Brook Children’s Services, explained in an email. “The impact on their development from having actually experienced COVID illness is minimal.”

Children hospitalized with more significant illness from COVID might experience temporary developmental regression which is common in children hospitalized for any reason. The developmental impact seems more tied to social isolation.

“Children born during the pandemic spent their first years of life rarely seeing adults or children other than those in their immediate family,” Walker said. “The result is that many of these kids became excessively stranger anxious and timid around others.”

The lost social opportunities, the pediatrician said, resulted in delays in the personal/social domain of development. She added, “The good news is that kids are resilient and, in time, with appropriate social stimulation, [these children] should be able to regroup and catch up developmentally.”

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After a November and December in which realities like a “tridemic” of viral threats sickened residents throughout Suffolk County, the new year has started off with fewer illnesses and cautious optimism among health care professionals.

“The numbers are coming down now,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. The overall threat is “less” and “we’re in the take-a-deep-breath phase.”

Indeed, the frequency of cases of several viruses is lower.

“Flu and RSV (respiratory syncytial virus) are down,” Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, explained in an email.

At the Catholic Health hospitals, including Port Jefferson-based St. Charles and Smithtown-based St. Catherine of Siena Hospital, the emergency room visits are down around 10% from a few weeks ago, said Dr. Jeffrey Wheeler, medical director of the Emergency Department at St. Charles.

In between too busy and too quiet, the hospital is in the “sweet spot” where health care providers have enough to do without frantically racing from one emergency to another, Wheeler said.

Among those visiting St. Charles, Wheeler added that health care providers are seeing a smattering of illnesses.

At the same time, the vaccine for the flu has proven to be a “good match” for the current strain, Nachman said. “Amongst those who did the flu shot, they have tended to not get sick enough to go to the doctor.”

According to New York State Department of Health figures, the overall numbers across the state have been declining for the flu. For the week ending Jan. 14, the number of infections was cut in half.

Suffolk County saw a slightly larger drop, falling 59% for the same week, to 571.

This year, people who were going to get the flu vaccine may have helped themselves and their families by getting the shot earlier, rather than dragging out the process of boosting their immune systems over the course of months. Nachman said.

Cases of monkeypox continue to be on the lower side, in part because of the number of vaccines people in the area have received.

To be sure, health care workers are still helping people overcome a range of infections circulating in the county.

“We are still seeing a smorgasbord of flu, COVID and RSV,” said Nachman. Of the people admitted to Stony Brook Hospital, most of them have a comorbidity.

At Huntington Hospital, admissions are “high,” and the hospital census remains high, Popp added.

Health care workers are diagnosing viruses like the flu and COVID-19 and have used available treatments to reduce the symptoms and the spread of these viruses.

New COVID vaccine approach

Earlier this week, the Food and Drug Administration posted documents online that reflected a possible future change in its approach to COVID-19 vaccinations.

Instead of recommending bivalent boosters or a range of ongoing vaccinations to provide protection against circulating strains, the FDA plans to approach COVID-19 vaccinations in the same way as the flu.

Each year, people who are otherwise healthy and may not have high risks may get a single dose of a vaccine based on the strains the administration anticipates may circulate, particularly during the colder winter months.

Health care professionals welcomed this approach.

Nachman and Popp thought a single shot would be “great” and appreciated how the annual vaccine would simplify the process while reducing inoculation fatigue.

“The simplest messages with the simplest strategy often wins,” Nachman said.

Bivalent booster concern

Addressing concerns raised by the Centers for Disease Control and Prevention about a potential link between the bivalent booster and stroke, Nachman suggested that was one data point among many.

Israel has used the Pfizer bivalent booster exclusively and hasn’t seen any such evidence linking the booster to stroke.

The CDC data is “one of multiple data points that we use to look at safety events,” she said. “Not a single other one has shown any relationship with stroke among the elderly in the first 21 days.”

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TBR News Media is endorsing Sen. Mario Mattera for this year's election. File photo by Raymond Janis

In an effort to influence the upcoming state budget, Republican officials in the New York State Legislature joined policy advocates at the Perry B. Duryea State Office Building in Hauppauge Thursday, Dec. 15.

The officials called the press event to raise public awareness about the lack of child care services on Long Island, hoping to pressure Gov. Kathy Hochul (D), who is preparing the state budget for the 2024 fiscal year.

Child care on Long Island “is not a problem, it’s a crisis,” said Dean Murray, state Sen.-elect (R-East Patchogue), who organized the event. “We are at a crisis level on Long Island when it comes to child care, and there is no simple solution.”

Murray regarded the issues associated with child care as threefold. For him, the state government can remedy the problem by addressing its affordability, availability and accessibility. 

While Murray applauded Hochul and the Legislature for targeting the issue in last year’s budget, he said the changes do not adequately account for regional economic differences throughout the state.

“The cost of living here on Long Island does not compare to areas upstate,” he said, “So when you have a statewide standard, it simply isn’t fair to regions like Long Island.” 

He added that the child care is underfunded, arguing, “We need to do what we can as a government to help to create more availability, helping to build more facilities, helping to encourage employers to offer on-site child care.”

The state senator-elect regarded child care service as “a profession, not a job.” However, he said these professionals are often underpaid.

“Can you think of a job that’s more important than caring for our kids?” he said. “This is a professional job. [The workers] need to be treated as such, and they need to be compensated as such.”

State Sen. Mario Mattera (R-St. James) explained the problem similarly. He detailed the underinvestment in child care personnel, saying the incentive is to pursue other industries.

“The people right now with child care are leaving because they’re getting other jobs,” Mattera said. “They’re getting better [paying] jobs even in McDonald’s. That’s a problem.” He added, “They are watching our kids and protecting our children, but they’re not getting paid properly.”

Mattera also addressed the need for more child care training programs. If child care is to be a profession, he said these service providers deserve similar specialized teaching to those of other fields.

“We need to educate,” the state senator said. “We need to make sure [institutions] like Suffolk Community College, a perfect example, have some kind of a course … to have qualified people watching our children.”

Jennifer Rojas, executive director of the Commack-based Child Care Council of Suffolk, discussed the adverse effects of the COVID-19 pandemic on the child care industry. While these essential services remained operational throughout the public health emergency, the industry has struggled since.

“When everything shut down in March of 2020, child care remained open because we knew how important it was for our essential workers to continue to work,” she said. “Unfortunately, our industry is in a crisis. … It’s expensive for parents, and the workforce is making poverty wages.”

She added, “It’s because you cannot raise the cost on parents in order to pay your staff more, so we’re stuck in this bubble where providers are not able to pay their staff and, therefore, not able to recruit.”

Without sufficient staff, Rojas said some child care programs are cutting back resources and, in some instances, shutting down altogether. “This is a crisis like we have never seen in this industry, and it’s always been an industry that has operated on razor-thin margins,” she added.

Above, state Assemblywoman Jodi Giglio (R-Riverhead). Photo by Raymond Janis

State Assemblywoman Jodi Giglio (R-Riverhead) echoed Rojas’ sentiments about the crippling effects of COVID-19 on child care service providers. To Giglio, the lockdowns generated conditions where child care was less necessary for parents.

“Because the moms couldn’t go to work and everybody was expected to stay home, a lot of these facilities closed down,” she said. “It costs a lot because your payroll is not going down and you’re still turning the lights on every day.” 

Also in attendance was Ryan Stanton, executive director of the Long Island Federation of Labor, who emphasized the inordinate expenses associated with child care and the need for state support.

“In both Nassau and Suffolk counties, the cost of care is about $30,000 a year,” he said. “That is more than going to the State University of New York for an entire year. You have working families struggling to make ends meet. In order to go to work, [they] must have care in many instances. And we’re asking them to pay for a college tuition bill or more.”

Giglio, a member of the state Assembly’s Labor and Economic Development committees, suggested funding child care to remediate labor shortages, viewing such an investment as an economic development tool.

“We have warehouses out there that are full of materials, waiting to be delivered to customers, and those items are not getting delivered because they don’t have the drivers,” she said. “We need to get people back to work. Employers are looking for workers, and parents are looking for a better life for their families.”

Concluding the press conference, Murray outlined some possible solutions. He recommended removing the statewide eligibility standard to resolve the regional economic differences between Long Island and the rest of the state.

“Because of our economic diversity here, [the statewide standard] doesn’t serve Long Island like it should,” the state senator-elect said. “Rather than a statewide eligibility level, we should break it into the 10 regional economic development council regions.”

With different standards for different regions, Murray maintained that Long Islanders could qualify for additional state aid for child care, reflective of their higher cost of living. “This is a fairer way, especially for Long Island families,” he said.

Murray said another way to improve the issue is through employer-based on-site child care. He offered that expanding these benefits could assist working families and employers alike.

Speaking to employers directly, he said, “If you offer on-site child care as a benefit to your employees, I guarantee you that will put you above your competition in the game of recruitment,” adding, “What we want to do is incentivize that.”

Lastly, he suggested exploring any changes in state regulations that may be holding up the construction of new child care facilities. “We also need to sit down and look at whether or not there are regulations slowing down the building of health care facilities,” Murray said. 

He added, “Let me be very clear: We will never change any regulations that deal with the health, the safety or the well-being of the children. But we should take a look at the regulations otherwise and see if they are slowing them down.”

Hochul is expected to release her proposed FY 2024 budget next month.

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People are waiting once again for COVID-19 and other tests at local urgent care centers. File photo by Lina Weingarten

Around this time of year, parking lots are often full.

That’s true of the mall parking lot, as people go out to shop for holiday gifts for their friends and family, but it’s also true, especially this year, for hospitals and urgent care centers.

With the so-called “tridemic,” which is a combination of viruses that typically affect the lungs, including COVID-19, the flu and respiratory syncytial virus (or RSV), infecting people of all ages, the need for health care and medical attention has been high in the weeks leading up to the holidays.

When Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, arrives at work at 7 a.m., she drives past urgent center parking lots that are “full for a reason. It’s because people are sick” and need medical attention at the start of the day.

Indeed, the combination of the three viruses, as well as other viruses and bacteria in the community such as adenovirus and enterovirus, has made it difficult for some children to attend schools and for adults to go to work.

For the week ending Dec. 10, which is the most recent period for which data is available, Suffolk County reported 3,936 cases of the flu, which is up 35% just from the prior week. The week ending Dec. 10 alone represents more than half of all flu cases for the entire 2019-2020 season, according to data from the New York State Department of Health.

At the same time, COVID and RSV numbers have climbed.

“We almost doubled our COVID census over the last three to four weeks,” Dr. Michael Khlat, chief medical officer at St. Catherine of Siena Hospital in Smithtown, explained in an email. St. Catherine currently has almost 60 COVID-positive patients. Nearly a third of those patients are admitted for COVID and are receiving intravenous remdesivir, while the others are incidental findings in the context of other medical needs.

“What is special about this surge is that it is inclusive of COVID, influenza, rhinovirus as well as RSV,” Khlat wrote. “The symptoms are very similar, and treatments are all supportive at this time.”

Family gatherings at Thanksgiving contributed to the increase, adding “extra turbocharging to the current respiratory viruses,” Nachman said.

The most vulnerable patients are the immunocompromised, patients with diabetes, chronic lung and cardiac disease, obese residents and patients with chronic liver and kidney disease, Khlat added.

Demand for beds

The influx of patients has meant that St. Catherine has had to increase its capacity of staffing using nursing agencies to meet the needs of the community for “seamless, high-quality care,” Khlat explained.

St. Catherine has also added more providers on the medical wards to care for patients and has load balanced patients with their Catholic services partner St. Charles Hospital and other Catholic Health facilities.

Nachman urged residents to see their primary care doctor if they have routine viral symptoms. Coming directly to the emergency room slows the process of delivering urgent care.

To be sure, Nachman urged anyone with chest pains or stroke-like symptoms should head directly to the emergency room.

Nachman said Stony Brook Children’s Hospital is transitioning to a model in which they triage patients who walk into the ER to assess the need for services.

As people prepare for family gatherings, Nachman suggested that they evaluate the risks of interacting with others.

People with an immune deficiency might want to wear masks or speak outside with others, particularly if someone in the group had one of the respiratory viruses.

Viruses like RSV are generally contagious for about three to eight days, according to the Centers for Disease Control and Prevention.

RSV spreads through close contact, which means that passing someone in a supermarket won’t likely spread the virus, while sitting and doing homework or eating a meal next to someone could.

As for COVID, Nachman continued to urge people to get the bivalent booster shot.

Every study, she said, shows that the booster drastically reduces the risk of being hospitalized with COVID.

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

The Centers for Disease Control and Prevention has advised Suffolk County residents to wear masks while at indoor public spaces regardless of their vaccination status

The recommendation is due to the increase in COVID-19 cases in the county. According to the Suffolk County Department of Health, for the week ending Dec. 3, there were 264-290 people hospitalized with COVID-19, and 14 died from the virus in the county. There were 4,168 new cases reported. The reinfection rate for Long Island increased from 10.3 to 18 per 100,000.

Flu cases have also increased. According to the SCDOH, during the week ending Dec. 3, flu cases increased in the county by 85%, from 1,577 confirmed cases to 2,916. 

In a video posted to the SCDOH’s social media pages, Dr. Gregson Pigott, county health commissioner, said the COVID-19, influenza and respiratory syncytial virus (or RSV) infection rates are surging in Suffolk. The cases are in addition to the rise of other common seasonal infectious diseases. 

“They are causing too many people to miss work or school and straining our health care systems,” Pigott said.

He urged residents to take precautions such as getting the vaccines for the flu and COVID, noting it is safe to take them together. He added the COVID bivalent booster “has shown to be effective against the older and newer strains of SARS-CoV-2.”

Pigott said the flu shot is a good match for this year’s circulating strains. Currently, there is no vaccine for RSV.

In the video, he reminded residents to wash their hands often and stay home when sick. He added that masks should be clean and well fitted, and used in enclosed public spaces.

“As we head into our third pandemic winter, let us be safe and do our best to protect one another,” Pigott said.

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METRO photo

The COVID-19 pandemic has brought unforeseen challenges for nearly everyone in our nation and world.

COVID-19 has already claimed the lives of 6.65 million people around the globe, 1.09 million of which are in the U.S. Countless more have been infected, with the illness hitting hardest the elderly and those with preexisting conditions. In this time, however, perhaps no demographic sacrificed more greatly than our youth. 

We made a decision: Would we let the kids — who were not nearly as vulnerable to the disease as their older counterparts — continue their lives as usual? Or would we limit their in-person activities and restrict their social gatherings to curb the spread of COVID-19? Given a choice between age and youth, we opted for age.

Many children were shut out from traditional social interactions during those critical early years of their emotional and psychological maturation. Sadly, many high school seniors lost their graduation ceremonies, proms and final sport seasons. 

In the absence of interpersonal connections, our young became increasingly dependent upon their technologies. Zoom sessions quickly replaced the classroom. Video games supplanted schoolyards and after-school hangouts. Their relationships with the outer world became mediated through a digital screen.

There is still much to learn about the long-term social and psychological impact of the pandemic on our youth. How will the frequent COVID scares, forced separations, quarantines and widespread social panic affect their developing minds? This remains an open question.

As we transition into the post-COVID era, we know that our young will have difficulty adapting. Right now, they need our help more than ever.

The generation that came out of World War I is often called the “Lost Generation.” A collective malaise defined their age following the shock and violence during that incredible human conflict. 

Members of the Lost Generation were often characterized by a tendency to be adrift, disengaged from public life and disconnected from any higher cause or greater purpose. Right now, our youngsters are in jeopardy of seeing a similar fate. 

Like the Great War, the COVID-19 pandemic was outside the control of our children, with the lockdowns and mandates precipitating from it. Yet, as is often the case, the young bore more than their share of hardship.

We cannot allow Gen Z to become another Lost Generation. They have suffered much already, and it is time that we repay them for their collective sacrifice. To make up for that lost time, parents and teachers must try to put in that extra effort. 

Read with them, keep up with their studies, and apply the necessary balance of support and pressure so that they can be stimulated and engaged in school. Keep them from falling behind.

Remember to limit their use of technology, encouraging instead more face-to-face encounters with their peers. These interactions may be uncomfortable, but they are essential for being a fully realized human being. Devices cannot substitute these vital exchanges.

As it is often said, difficult times foster character and grit. Perhaps these COVID years will make the young among us stronger and wiser. But we must not allow the COVID years to break them either. 

Despite their lost years, with a little effort and love they will not become another lost generation.

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A study of more than 8,000 women from seven countries revealed that at the onset of the Covid-19 pandemic, stress experienced by pregnant women predicted more frequent anxiety and depressive symptoms. Photo provided by Marci Lobel, Stony Brook University
Published study of more than 8,000 women from seven Western countries reveals mental health risks at onset of pandemic

A study that assessed stress, anxiety and depressive symptoms in pregnant women from seven Western countries during the first major wave of the Covid-19 pandemic (April 17 to May 31, 2020) shows that stress from fears about Covid-19 led to anxiety and depressive symptoms above normal levels. Led by Stony Brook University Professor Marci Lobel, PhD, the findings are part of the International Covid-19 Pregnancy Experiences (I-COPE) Study and are published in Social Science & Medicine.

The Covid-19 pandemic has had unprecedented impact on public health, including mental health, and has affected social and economic conditions of people worldwide. The onset of the pandemic was especially stressful for pregnant women because of the initially unknown effects of the virus on fetuses, and because prenatal care and labor and delivery practices were greatly altered. The I-COPE Study is the first major research project to compare stress and mental health in pregnant women across these Western countries.

The study involved 8,148 pregnant women (on average about 27 weeks pregnant) from the United States, Germany, Switzerland, Spain, Poland, Italy and Israel. While the countries varied in magnitude of pandemic-related pregnancy stress – likely because of cultural differences and the specific impacts of the pandemic in each country – anxiety and depressive symptoms among the cohort were strongly predicted by pandemic-related and pregnancy-specific stress – a result the authors found was replicated within the individual countries.

”Our findings show that the stress experienced by pregnant women predicted more frequent anxiety and depressive symptoms, including symptom levels above clinically defined thresholds for poor mental health,” explains Lobel, Director of I-COPE, and a Professor in the Department of Psychology and the Department of Obstetrics, Gynecology and Reproductive Medicine at the Renaissance School of Medicine at Stony Brook University.

Among the seven countries, rates of moderate and severe anxiety symptoms ranged from 14.2 percent to 36 percent, and rates of likely depressive disorder ranged from 10.8 percent to 30.5 percent. Rates of both types of mood disturbance among women in Germany, Poland and the U.S. exceeded global ranges reported by analyses prior to the pandemic. Pregnant women who were younger or pregnant with their first child, those with high risk conditions, and those with limited access to the outdoors reported higher stress, and high stress in turn predicted the mood disturbances examined in this study.

Lobel and colleagues point out that many pre-pandemic studies – including those centered around other traumatic communal events such as the aftermath of natural disasters or terrorist attacks – also find evidence that prenatal stress is a risk factor for adverse maternal, fetal, infant, and child outcomes. Yet comparisons of these effects across multiple countries are rare, and the ability to examine them in the context of a global health crisis, when stress and its consequences are heightened, is unparalleled.

In 2021, Lobel and colleagues showed in another published study of women in the U.S. that prenatal stress during the pandemic onset also predicted worse birth outcomes, including greater likelihood of preterm birth or delivery of a newborn small for gestational age.

The authors conclude that results of the I-COPE Study confirm that stress from the pandemic is a strong, common predictor of anxiety and depressive symptoms in pregnant women. They add that the results “can be used to inform research and clinical interventions to protect against adverse consequences of prenatal stress, anxiety, and depression, as these mental health impacts pose longer-term threats to the health and well-being of women and their offspring.”

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By Daniel Dunaief

Daniel Dunaief

I’ve been on a long journey that’s taken me around the world for more than two and a half years. Many hosts have provided for me, enabling me to grow and, in some cases, make changes.

I don’t recall the beginning. The first host I remember was an incredibly kind doctor. She spent countless hours caring for others, looking into their eyes, assuring them she would do everything she could for them.

She was so focused on helping others that she didn’t even know she was hosting me. I stayed quiet just long enough to make the jump to a famous American actor who was working in Australia.

He and his wife didn’t enjoy their time with me. They warned the world about me and my extended family.

My next host was a businessman. He had been in a hospital with his son, who had a broken leg. The businessman stayed in the waiting room for hours, trying to do his work but unable to focus because he was so concerned about his boy.

Finally, after hours of surgery, the doctor came out to talk to him and that’s when I found a new host.

This businessman worked hard. Once he discovered his son was safe, he ignored me and my needs.

I developed without anyone noticing me. At one point, I heard someone come looking for me, but I hid just far enough away. I traveled a great distance on a plane with him. Once we were in a new country, I had so many choices.

Realizing it was time to go, I jumped to an elderly bus driver. He was a gentle man. The lighter laugh lines near his eyes looked like waves approaching the shore on his dark chocolate skin.

Before he collapsed into bed the second evening we were together, he seemed to be staring directly at me. In his house, I had a choice of other possible hosts, but decided to hitch a ride with his son.

That one almost cost me my life. His son soon realized I was there, and he stayed away from everyone. I was curled up alone with him. He barely moved for long periods of time, except when he coughed or sat up and sent text messages and emails. One night, when he was finally sleeping, a man came into his room to clean it. That’s when I escaped.

This man didn’t even know he hosted me. He wasn’t stuck in bed, and he didn’t cough. I traveled with him to several events. After other trips, I found an important politician. We took a ride in a helicopter and went to a hospital where doctors provided all kinds of new medicines.

I became like a game of telephone, passing along from one person to the next. And, like a game of telephone, the message changed, as I demanded different things from my host.

I found myself at a concert with a young woman who sang and danced for hours. She looked so vibrant and full of life.

She was a friendly enough host, until I set up camp with her mother. Then, she shouted at me, praying to keep me away. She took me to a hotel, where she seemed to stare at me while she prayed.

When someone delivered food and walked in the room to wait for payment, I made the jump to him. During the day, he was a student with a full and busy life. I didn’t stay long, moving on to his girlfriend, her roommate, and, eventually, to a professor.

I stayed with the professor for over a week. She spent considerable time grading papers, writing at her computer, talking to family members, and taking medicine.

I have made some changes along the way. I don’t travel with as much baggage as I used to. I know people think I’m not as much of a burden as I was in the early days. My most recent host would disagree. He couldn’t talk, had trouble sleeping and was exhausted all the time. I’m getting ready to travel the world again this fall and winter. You can ignore me all you want, but I’m still here, making changes and preparing to find more hosts.

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Doctors suggest getting immunized before the holiday gathering season begin. Stock photo from Metro

This fall and winter, several infections have their sights set on your lungs.

Amid threats from diseases that affect other organ systems, three of them — COVID-19, the flu and respiratory syncytial virus — can and often do attack the lungs.

While the current strain of COVID isn’t as lethal as the original, the virus continues to mutate, leading to new strains and, potentially, to different strains later this fall.

At the same time, the flu and RSV have been waiting for an opening after COVID protections like masks also kept them at bay during 2020 and 2021.

“How bad is the winter going to be?” asked Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “It will be based on more [COVID] variants coming through, with a strong flu season, which is never something you want to see.”

The number of cases of respiratory illnesses like RSV and the flu has been lower in the last few years. The lack of exposure to those viruses, however, may give them an opening for a stronger return in the population.

These viruses “didn’t paddle along for a while,” Nachman said. “Now, they are paddling furiously. Everyone is seeing them.”

People’s immune systems may not be prepared for the threat from these recurring viruses.

When people arrive at the hospital, health care officials often see the same symptoms, with coughing and sneezing.

“It could be one, two or three” causes at the same time, Nachman said.

The combination of contracting more than one virus at the same time could lead to prolonged and painful illnesses.

COVID reality

Much as people would like to return to a pre-pandemic reality, the SARS-CoV2 virus not only continues to infect people, but it also remains something of an evasive target, with mutations leading to new variants.

While area hospitals don’t test for the specific COVID strain when patients are sick, doctors expect that some of the people who have contracted the disease have the modern variants.

“Undoubtedly, many cases that are coming to our Emergency Department are due to the new Omicron sub-variants,” said Dr. Sunil Dhuper, chief medical officer at Port Jefferson’s St. Charles Hospital. “Information from the Centers for Disease Control and Prevention has shown that Omicron BA.5 cases are trending downwards and the cases due to the sub-variants are on the rise.”

“The purpose of the vaccine is to attenuate the symptoms from the virus and reduce the severity of illness, hospitalizations and/or death.”

— Dr. Sunil Dhuper

Symptoms of the newer variants are similar to others, with fever, chills, cough, runny nose, fatigue, muscle or body aches, shortness of breath, loss of smell or taste, sore throat, nausea or vomiting and diarrhea, Dhuper explained.

Doctors said it was difficult to gauge how effective the new bivalent COVID vaccines are against the latest strains.

The latest booster may “not be active against all the coming variants,” explained Dr. Phillip Nizza, attending infectious disease physician at St. Charles Hospital.

The new booster was designed to enhance the reaction to the BA.4 and BA.5 variants.

“We don’t have enough data” to determine the effectiveness of the booster against current and future threats, Nachman said. “How effective it will be depends” on differences between the booster and the strain someone contracts.

Still, the vaccine is likely to provide some benefits, doctors said.

“The purpose of the vaccine is to attenuate the symptoms from the virus and reduce the severity of illness, hospitalizations and/or death,” Dhuper wrote. “And I think the vaccines would be very successful in accomplishing that objective.”

Even for people who have been infected recently with COVID, Nachman urged people to get a booster.

The combination of an infection and a booster “Is always better than not getting a vaccine,” Nachman said. “You should get a vaccine. The timing is tricky” and could involve getting a dose two weeks after contracting the virus or waiting.

The viral threat during the December holidays, in particular, is higher, so Nachman urges being as immunized as possible before then.

With people not wearing masks and not even testing for the virus even when they get sick, Nachman suggested that it’s “highly likely” the country will see new variants by the spring.

Nachman urged people to take steps to protect themselves, which includes eating well, exercising, receiving the latest vaccination and limiting exposure, particularly for those who might be vulnerable.

“Take care of yourself,” Nachman urged.

At Stony Brook University Hospital, the wards are busy, with a steady stream of patients coming in, receiving treatment and getting discharged, Nachman said.

“We’re seeing a lot of other viral illnesses,” she added.

She sees a ramp-up in RSV, which she doesn’t expect to peak until Thanksgiving.

Dhuper remains concerned about viral threats this fall and winter.

“We do anticipate a worse flu season this year as the herd immunity is at a lower level,” he wrote. “People should get their flu shots sooner rather than later as that is the only primary protection we have to offer. People with comorbidities should particularly be concerned as the likelihood of severe illness, hospitalization and even death could be higher without the protection from the vaccine.”

While Nizza hasn’t seen any major spike in the flu yet, he suggested in an email that “now would be a good time to get vaccinated.”

Got all that? Good, now, when you’re outside, far from other people and you want to give your lungs a break, take a deep, cleansing breath. Other times? Protect your health and the health of your family and community.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

My grandmother was a worrier. 

Even she, however, would have had a hard time worrying about other major challenges, problems and threats during the worst of the COVID-19 pandemic.

That, it turns out, was also true for the world during COVID when it came to discussions about the threat from climate change.

In a recent study published in the prestigious journal Proceedings of the National Academy of Sciences, Oleg Smirnov, associate professor in the Department of Political Science at Stony Brook University, examined the level of concern on Twitter about climate change during 2020 and 2021 and compared those numbers to 2019, the last year before COVID.

According to the pool of finite worry, which Princeton professor of Psychology Elke Weber developed, environmental and climate concerns decline amid worries about other major threats.

Smirnov found that the total number of tweets that mention climate change dropped to 5.6 million in 2020 and 5.3 million in 2021, from 8 million in 2019. This, Smirnov points out, occurred despite an increase in Twitter users, more climate disasters and more climate news in 2021.

“The psychological foundation tell us that people may only really respond to one threat at a time,” Smirnov said in an interview. The anxiety and the reaction to that threat may be limited because it requires major energy.

“Maybe, for biological reasons, [people] put all their energy into responding to the most immediate threat,” Smirnov added.

By tracking daily tweets and various measures of COVID cases, Smirnov found on a finer scale as well that discussions of climate change diminished amid higher infections and mortality.

For every thousand new COVID-19 cases in the United States, climate change tweets decreased by about 40.5 tweets per day. Every thousand new deaths resulted in 3,308 fewer climate tweets.

While Smirnov understood the need to focus on the pandemic, he suggested a lack of concern about climate change could disrupt efforts to protect the planet

“This has profound implications,” Smirnov said. “Without a focus on climate change, without an emphasis on its importance, there is less urgency and less pressure on politicians to do something about it.”

Even in better times, climate change efforts are “fragile,” he said, which adds to the uncertainty about the ability to address the challenge adequately.

Indeed, even the sentiment analysis, in which Smirnov reviewed the emotional content of words used to describe climate change and the threat to the planet and humanity, became less negative during the worst of the pandemic.

When asked about the possibility that climate change concerns might have declined during COVID in part because the carbon footprint declined amid travel restrictions and slowdowns in industrial production, Smirnov likened such an approach to short-term fasting or extreme dieting.

While spending a few days on these extreme diets can reduce a person’s weight over the course of days, such an approach provides “no substantial improvement in your health” longer term, he said.

So, what about now, as concerns about the pandemic abate, people have stopped wearing masks and schools and stadiums are full?

Smirnov plans to continue to collect Twitter data for the remainder of this year, to see whether a return to normalcy brings the focus back to the threat from climate change.

As for his own experience, Smirnov recognized that climate change took a back burner amid the worst of the pandemic.

“My attention certainly was hijacked by COVID-19, despite the fact that climate change is part of my work,” Smirnov said. In April of 2020, Smirnov recalled worrying about where his family would find food instead of thinking about greenhouse gases and rising sea levels.

In the present, Smirnov remains concerned about the kind of tipping points and climate inertia that threatens the future.

Ever the worrier, my grandmother might be relieved enough by the less virulent form of the virus and the availability of vaccines and treatment to return to worrying about the threat climate change poses.

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