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Covid 19

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By Leah S. Dunaief

Leah Dunaief

This message is for older people who are reading this column and may get COVID-19. The information may save your life. It may have saved mine.

Especially for older people, COVID is a deadly virus. What defines older? Let’s say, beyond 50. Now there is a medicine that dramatically reduces severity and possible death from this virus, but many Americans are not taking it. Its name is Paxlovid.

“Never really in recent history for a respiratory virus can I think of an anti-viral medication being as effective, demonstrated in scientific literature, as what Paxlovid has shown,” stated Dr. Rebecca Wang, an infectious disease specialist at Dartmouth Hitchcock Medical Center, when interviewed by The New York Times.

Both random trials and data from electronic health records have shown this medicine to be effective, particularly among older patients. The medicine works by inhibiting the virus’s replication once it invades the body. Its underuse is already associated with thousands of preventable deaths, according to Dr. Robert Wachter, chair of the medicine department at the University of California, San Francisco.

“A large chunk of deaths are preventable right now with Paxlovid alone,” Dr. Ashish Jha, the White House COVID response coordinator told David Leonhardt of The New York Times. He predicted that if every American 50 and above with COVID received a course of either Paxlovid or monoclonal antibodies, daily deaths might fall to about 50 per day, from about 400 per day.

So why aren’t people taking the medicine?

For one reason, Paxlovid, which is taken twice a day for five days, does leave a metallic taste in the mouth. So I found that by eating half a banana after each dose, I got rid of the unwelcome taste. I also got the benefit of a banana a day, which is a healthy and nutritious fruit containing fiber and some essential vitamins and minerals.

Another possible reason is the association of Paxlovid with “rebound,” a second session of the disease which can occur a week to a month after the end of the first round. Experts don’t know what causes the rebound. A rebound is possible even if the patient never used Paxlovid. And even if he or she did, perhaps a longer duration of the drug is necessary for some patients than the five days currently administered.

Research has shown that out of sample of 568,000 patients, 0.016% over 50 who used Paxlovid died. For a similar cohort of patients who did not use the drug, the death rate was four times higher or 0.070. But only 25% of patients eligible to receive the drug actually took it, even though it is available and free.

Thanks to my son, Daniel Dunaief, who has spoken with two infectious disease experts, we also have some local reaction to the drug. Dr. Andrew Handel, pediatric infectious disease physician at Stony Brook Children’s Hospital, commented, “Hesitancy to take Paxlovid seems to fall in line with the general ‘COVID fatigue.’  COVID is clearly less lethal now than during prior surges, thanks in large part to vaccinations, but it still causes some hospitalizations. Those at highest risk of severe disease, particularly those who are unvaccinated, benefit from antiviral treatment if they are infected.”

Dr. David Galinkin, infectious disease expert at St. Charles Hospital, said, “The media has overblown this rebound experience. In the literature, about 10% of cases [have a rebound.] Like any other medication, people that could really benefit from Paxlovid [should consider it.] … We are still seeing people dying from this.”

Perhaps more doctors could be better informed about this drug. Additional information and encouragement are needed from the White House, and a lot more public announcements should be placed in the media to reach people. As has been the case throughout these last two-and-one-half COVID years, instructions have been changing, adjusted as the scientific and medical professions learn more about this pathogen. Proper treatment is still a work in progress.

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Insomnia. METRO photo

By Leah S. Dunaief

Leah Dunaief

Have you been waking up thinking at night? There is so much to think about, even to be deeply concerned about. There is COVID-19, of course. No one wants to get the disease, and if you already had it, you don’t want to get it again, as some people reportedly have. You also don’t want any of the long-hauler symptoms to afflict you: fatigue, brain fog, aches and pains, trouble breathing, dizziness, headache, and at least nine more on a reported list. In fact, the list is so comprehensive, it’s enough to give you anxiety, especially if you already have had the illness. Oh yes, and anxiety is also one of the symptoms.

Then there is the Ukraine. Normally a country that was somewhere in Eastern Europe, in the same general area as “Fiddler on the Roof,” now its whereabouts as Russia’s western neighbor are known around the world. We watched as Putin sent more than 100,000 soldiers to overrun its borders. Poor little Ukraine, horrid bully Russia. We are sending them an unprecedented amount of money and military aid, and we have lowered our national oil and gas supplies. Will we have enough resources if we are attacked? Even as we cheer the valiant resistance and success of the victims of naked aggression, we worry about Putin’s possible use of nuclear arms. He has over 2000 small such weapons, apparently, and it’s the Cold War all over again.

The problem of immigration was brought right to our door with the arrival of immigrants sent by southern governors of border states. They have been literally deposited here by the thousands via buses, and they have been humanely received, if we are to accept what we are told by the media. As I have written in this column before, they can represent an opportunity as well as a challenge for areas in need of Help Wanted. Indeed, I am now reading that some of the immigrants are put to work cleaning up the devastation wrought by hurricane Ian in Florida. They are even being sent back down there to help. Who knows what to believe?

If you are going into New York City, how likely are you to ride the subway? The reports of incidents underground are frightening. So are horrible, unprovoked attacks on the streets. Now, I grew up in the city, and I am used to all sorts of miserable statistics concerning crime there, but I somehow never felt fearful. With some eight million people, crime is unfortunately inevitable. And NYC isn’t even statistically the worst. New Orleans is. But somehow, these recent incidents seem more violent.

Climate change has finally penetrated national conversation. The destruction and deaths in Puerto Rico and now in Florida and the Carolinas caused by the last two hurricanes have made those of us who live on islands and along the shores more conscious of future threats. While there have always been hurricanes, some with even legendary force, the prospect of more and stronger blasts due to climate change has prompted scary instruction about emergency bags and escape routes.

Inflation and its direction are also of grave concern. Going to the supermarket now seems to net about half as many bags of groceries for the usual food budget. Restaurants have decidedly become more expensive, as they have to pay more to function. And home values seem to have stopped rising and begun to cool. The stock market, while it is not the economy, has dropped like a rock. That negates the “wealth effect” homeowners and investors feel that encourages them to spend more freely.

Heck, I even worry about the New York Yankees. Yes, they have won their division, and you might say, “handily.” That’s exactly the problem. The last time they won by a big margin, they lost their competitive edge, along with the series, remember? It even happened this year right after the All-Star break. Teams do better when they have to fight until the last minute.

Awww, forgeddaboutit! Go back to sleep.

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Babak Andi holds a 3-D model of the coronavirus responsible for the COVID-19 pandemic. Photo courtesy of BNL

By Daniel Dunaief

For close to two and a half years, the world has had a microbial enemy. The SARS-CoV2 virus, which causes Covid-19, has resulted in close to 6.5 million deaths, caused lockdowns, restricted travel, closed businesses, and sickened millions. The key to fighting such a dangerous enemy lies in learning more about it and defeating its battle plan.

Working with principal investigator Daniel Keedy, Assistant Professor at the City University of New York and Diamond Light Source in the United Kingdom, Babak Andi, who is a beamline scientist from the structural biology group at Brookhaven National Laboratory, spent over two years studying a key viral enzyme.

Recently, the researchers revealed the structure at five temperatures of an enzyme called Mpro, for main protease. This enzyme, which separates proteins the virus makes, is critical for the maturation of the SARS-CoV-2 virus particles. They published their work in the Journal of the International Union of Crystallography (IUCrJ).

Using the Frontier Macromolecular Crystallography (FMX) beamline at the National Synchrotron Light Source II at BNL, Andi collected data on the structure of the enzyme at temperatures ranging from 100 degrees Kelvin, which is about negative 280 degrees Fahrenheit, all the way up to 310 degrees Kelvin, which is normal body temperature. “Nobody had done that, specifically for this protein,” said Andi.

Keedy, who guided the data collection, processed the information and wrote most of the paper, described the effort as a “great collaboration.” The gradual change in the conformation of the enzyme helped the scientists learn how it may move or shape-shift in general, he explained.

Keedy had worked with BNL in the past and pursued research at the FMX beamline because the scientists at BNL had “been working with Mpro on site, and were very approachable and open to the idea.”

Finding the specific structure of important proteins like Mpro can help researchers, pharmaceutical companies and doctors search for inhibitors or small molecules that could be specific to these proteins and that might interfere with their function.

Andi and other scientists at this beamline worked through the pandemic shutdown because of the potential practical application of what they were doing.

“We almost had all the infrastructures in place to allow other scientists to connect and operate the beamlines remotely, enabling them to collect data on Covid-19 virus proteins,” said Andi. “In my opinion, being able to support all the academic and industrial scientists to collect data for Covid-19 research was our greatest achievement during the worst period of the pandemic.”

While coming into the lab in those early months raised concerns about their own health, Andi and his colleagues, who developed safety protocols, felt an urgency to conduct this research.

“When Covid hit, we had a sense that this is our duty, this is our job to contribute to this field, to make sure that every scientist who works on Covid-19 had easy access to our beamlines, facilities and all the tools [necessary] to make new drugs,” said Andi. 

How they solved the structure

The technology for the beamline enables Andi and other scientists to collect data quickly and even remotely. Speed helps because the longer x-rays hit a protein, the more likely they are to cause the kind of damage that makes determining the structure difficult, particularly at higher temperatures.

The first step in this research was in producing this protein, which Andi’s collaborators at BNL in the biology department provided. The biology department also helped with crystallization.

Andi prepared the beamline and aligned the x-ray beam, which are necessary to collect data.

The scientists rotated and moved the crystal through the x-ray, distributing the beam over the length of the crystal to minimize radiation damage.

The small size of the x-ray beam made it possible to keep the beam focused on the smallest dimension of the structure. The researchers studied the crystal at five different temperatures, starting at cryogenic all the way up to physiological.

Of the 195,000 structures listed in the Protein Data Bank, or PDB, only five had been determined at body temperature. That includes two from the group of collaborators who participated in this study.

Andi collected three or four data sets at each temperature.

“The different conformations we saw may inspire a new twist on antiviral drug development that targets a different place in the protein, but with a similar or better effect,” Keedy explained.

The researchers did not include other factors that might affect the conformation of the protein, such as pH, pressure, the number of ions or salts in the environment, among others. For the Mpro protease to work, it has to bond to another similar protein, forming a dimer.

Andi said the Pfizer treatment Paxlovid binds to the active site of this enzyme, inactivating it.

The drugs he is looking for are similar, although he is also searching for other places on the enzyme besides its active site.

Keedy hopes to try to make a monomeric form of the enzyme through a mutation. He could then find drug-like small molecules that target the exposed interface between the two copies.

BNL origins

After he completed his PhD and post doctoral work at the University of Oklahoma, Andi started his career at BNL 11 years ago as a post doctoral researcher.

During his childhood, Andi was initially interested in astronomy. When he enrolled at a university outside the United States, he took an entrance exam.

“Based on your score, it tells you which discipline of science you can go into,” he said. His score directed him to the field of cell and molecular biology.

“I’m happy this happened,” he said. “I find that I’m actually more interested in molecular biology than in astronomy.”

Outside of work, Andi enjoys do-it-yourself projects. Astronomy also continues to appeal to him, as he is fascinated with astrophotography and reads astronomy articles.

As for the work with a Covid enzyme, Andi hopes he has other opportunities to contribute. 

“I am interested [in continuing] the research in this field,” he explained. “That depends on time, resources and current or future priorities.”

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Photo from Deposit Photos

Now available at a doctor’s office or pharmacy near you: the latest COVID-19 booster.

Last week, the Food and Drug Administration gave Pfizer and Moderna Emergency Use Authorization to start distributing their newest COVID booster, which includes protection against the highly infectious Ba.4 and Ba.5 strains of omicron.

A few days later, the Centers for Disease Control and Prevention approved the administration of the booster.

Area doctors welcomed the news and suggested the newest booster would be helpful for certain groups.

“I suspect that, at a minimum, those who needed to get a fourth booster (elderly, comorbidity, immune issues) should get” it, explained Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, in an email. “I believe that its approval will include all individuals over age 12.”

Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/ Northwell Health, agreed that senior citizens and immunocompromised people should consider the latest booster.

With other shots available until now, residents may need to consider how much time to wait between boosters.

People are eligible for another booster two months after a previous COVID vaccine, according to the FDA website.

The FDA authorized single doses of Moderna’s booster for people 18 and over and Pfizer’s booster for those 12 and older.

The incidence of hospitalizations among people who have COVID at area hospitals has remained fairly stable during the summer. Stony Brook University Hospital has about 50 COVID inpatients each day, while Huntington Hospital has about 11.

Doctors cautioned, however, that those numbers include people who are hospitalized for other procedures or treatments and who test positive as a part of the hospital’s effort to monitor the pandemic.

“The vaccines, to a large extent (primary series plus a booster-protection) are working quite well” at preventing the need for hospitalizations, Nachman wrote.

Doctors urged people to take steps to protect themselves, their families, and their communities against contracting the virus.

“With the virus changing, it’s even more important to keep yourself and your family safe from getting COVID again and remain vigilant about taking precautions, i.e. hand washing, social distancing, mask wearing,” Nachman added.

A minority of residents treated with Pfizer’s antiviral therapy Paxlovid have experienced a rebound, testing positive days or even a week or more after receiving the antiviral treatment.

“Viral rebound occurs in about 10%” for those who have taken Paxlovid, with the majority in the older age groups, Nachman wrote. Having said that, the rebound we are seeing has not led to Emergency Department visits or hospitalizations.” 

As for mental health issues, residents of Suffolk County, as with other communities, have generally seen an improvement amid a relaxation of restrictions that limited social contact and kept people from their routines.

“Mental health issues were mostly related to the isolation mandates that were required to slow the spread of COVID,” Popp explained. “The reduction in restrictions has improved the mental health issues for many people.”

Monkeypox vigilance

Area hospitals continue to remain on the lookout for potential outbreaks of monkeypox.

“We are aggressively evaluating all suspected cases of monkeypox and have protocols in place for testing as well as treatment,” Nachman wrote. “We will be rolling out a [National institutes of Health] funded clinical trial for treating individuals across the ages with TPOXX.”

Huntington Hospital has had two confirmed cases of monkeypox. Popp expects the virus will “likely continue to spread.”

Several medical facilities continue to administer the limited monkeypox vaccines.

SBUH is working with the Suffolk County Department of Health to provide vaccinations at the Edie Windsor Healthcare Center in Hampton Bays.

On the official Suffolk County website, eligible residents can schedule monkeypox vaccinations through Northwell Health at the Bayshore Mall on Sunrise Highway.

As for the flu, Nachman urged residents to get their vaccines prior to the start of the seasonal flu season, sometime between now and November.

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Amid the typical questions about returning to school, such as finding friends in their classes and navigating to the right room at the right time, students on Long Island and elsewhere are preparing for the third year of the pandemic while other health care concerns loom.

As the summer enters its final weeks, health officials have found mosquitoes that have the West Nile virus, monkeypox has become a national health emergency, and Rockland County and New York City have reported cases of polio.

With all those health concerns, however, medical officials emphasized numerous pieces of good news that they hope will provide less of a disruption to communities, parents, teachers and students.

For starters, the Centers for Disease Control and Prevention last week eased some COVID-19 restrictions. In the past two years, some students had switched back and forth from in-person to remote learning after a positive test.

The CDC advises students, staff members and workers who were exposed to a person who tested positive for COVID-19 to wear face coverings for 10 days and to get tested, instead of urging them to quarantine.

At the same time, the CDC is no longer suggesting that unvaccinated students get tested regularly in order to attend school.

“Part of the reason they’re easing the restrictions is that the current strain that’s circulating is fairly non aggressive, there are not a lot of hospitalizations and there is not a lot of severe illnesses,” said Dr. Philip Nizza, chief of Infectious Disease at Mather Hospital and attending infectious disease physician at St. Charles Hospital.

The cases Nizza has seen in the hospitals are “very mild” and he hasn’t had an intensive care unit patient with a ventilator in well over a month.

Dr. Susan Donelan, medical director of the Healthcare Epidemiology Department at Stony Brook Medicine, suggested that the shift in the CDC guidance likely reflects the reality that non-pharmaceutical mitigation measures are of more limited use in an era when opportunities exist to receive effective vaccines, which are well tolerated, and safe therapeutics have become a tool to manage those people who are acutely affected.

“The shift now appears to be focused on self-assessment of risk [for self, close family members or others who may be adversely impacted if infected] and thus individual risk mitigation,” Donelan explained in an email.

Still, Nizza, among other health care providers in Suffolk County, urged people to continue to receive vaccinations and to stay up to date with their boosters.

Nizza suggested that a new booster, which could provide protection against the infectious Ba.5 omicron strain that has become the dominant variant in the county and in the United States, could be a “game changer.”

Doctors cautioned people in higher risk groups, such as those who are immunocompromised, have chronic lung disease or are significantly overweight to be vigilant about their exposure to the SARS-CoV2 virus, which causes COVID-19.

As of earlier this week, Suffolk County reported a 7.8% positive test rate on a seven-day average using lab-reported PCR tests, which doesn’t include the rapid tests. At the same time, the number of positive cases on a seven-day average stood at 33.8 per 100,000, according to the New York State Department of Health.

“If you’re not a high-risk patient the danger zone is lower,” said Nizza.

Monkeypox

Meanwhile, monkeypox continues to be a threat to the county, the state and the nation, as the availability of vaccines against the virus lags the need for shots.

New York State continues to have the greatest number of cases of the virus, with close to 2,300 out of about 12,000 cases in the country, according to the CDC. Most of the New York State cases are in the city.

The virus has affected men who have been intimate with other men, although the virus can spread through physical contact.

Nizza described monkeypox as “generally a nonfatal infection with a high presentation rate amongst the undocumented high-risk groups,” he said. “I don’t think the general population needs to rush out and get the monkeypox vaccine, unless [you] are in a high risk group.

Nizza doesn’t anticipate that the virus will spread at anywhere near the rate that COVID did.

“There is a vaccine available, which is much different than COVID, which caught us unaware,” he added.

West Nile virus

As of earlier this month, 38 mosquitoes had tested positive for the West Nile virus, including samples in Setauket and Port Jefferson Station.

The virus was first detected in birds and mosquitoes in Suffolk County in 1999.

People who contract the virus typically experience mild or no symptoms. In a small number of cases, people can have high fever, headaches, stiff necks and may have vision loss, numbness and even paralysis.

Symptoms can last several weeks and the neurological effects can be permanent.

The CDC recommends people use insect repellent to reduce the chance of getting bitten by a mosquito that harbors the virus. Additionally, reducing any standing water around the outside of the house cuts back on the opportunity for these virus-bearing insects to breed.

Suffolk County Health Commissioner Dr. Gregson Pigott recommended that people minimize outdoor activities between dusk and dawn, make sure windows and doors have screens and, at places where mosquitoes are active, wear shoes and socks and long pants and long sleeved shirts.

As of late last week, Mather and St. Charles didn’t have any reported cases of West Nile virus.

The people who are especially vulnerable include the elderly and anyone on drugs that suppress their immune systems.

Polio

Health officials in Rockland County and New York City reported two cases of people with polio.

This disease, which spreads from contact with infected feces, has been largely eradicated after the widespread use of an effective vaccine.

“Most people have their children vaccinated as a part of a routine series,” Nizza said. “It’s a much lower risk.”

The doctor urged people to remain vigilant about other threats that might come this fall, particularly the flu.

With masks and social distancing, the incidence of the flu declined over the last few years. As people return to work and school on a full time basis, the chance for the spread of a problematic strain rises.

“The flu is always bound to rear its head in the fall and winter months,” Nizza said, as he reminded people to get their shots and to continue to wash their hands before eating.

Even if people feel healthy and are in low risk groups, they can and should help others the way they might lend a hand to their neighbors after a storm.

“We have to protect those who have a high risk of mortality,” Nizza said. “We need herd compassion, to protect those who can’t protect themselves.”

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Anthony Figliola (left) and Nick LaLota (right) tackled a range of issues during Monday’s Zoom debate. LaLota’s photo from candidate’s websites; Figliola’s from candidate

Two candidates took to the virtual debate stage on Monday, Aug. 8, as the Republican primary contest for New York’s 1st Congressional District ramps up to succeed Rep. Lee Zeldin (R-NY1), who is a state gubernatorial candidate.

Hosted by the League of Women Voters of the Hamptons, Shelter Island, and the North Fork, declared Republican congressional candidates Anthony Figliola, of East Setauket, and Nick LaLota, of Amityville, squared off for the second time. The debate moderator was Estelle Gellman, who asked questions that were submitted in advance by the public. The third candidate in the race, Michelle Bond, declined the invitation to participate, according to Gellman.

The winner of the Republican primary race will likely face Suffolk County Legislator Bridget Fleming (D-Noyac), the presumptive Democratic nominee, in the general election this November.

Introductions

Figliola was born and raised in Rocky Point and currently resides in East Setauket. After serving as deputy supervisor of the Town of Brookhaven, he is executive vice president of a government relations and economic development business, according to his website. He said he entered the race due to a sense of frustration with Washington, which he believes has neglected ordinary citizens.

“People are hurting tremendously,” he said. “What’s happening is that Washington is not listening to them. I’m a regular working-class individual. Our family, we’re in the struggle with you. We understand what’s going on and I think we need someone who’s a regular, working-class person that’s going to fight for the people of this district.”

LaLota is the designated candidate for both the Republican and Conservative parties of Suffolk County. After graduating from the United States Naval Academy, he was deployed three times overseas and is a former Suffolk County Board of Elections commissioner. He said he is running to address the numerous complex issues facing the nation.

“There are important issues that we need to tackle as a nation,” he said. “Issues with respect to the economy, inflation, public safety, the border, protecting our constitutional freedoms — I’m eager to tackle those issues in Congress. There are good Republican and Conservative solutions to each one of those issues.”

Gun violence

After a proliferation of recent mass shootings around the country, the candidates were asked whether they would support additional restrictions on access to firearms, such as a ban on assault weapons or high capacity magazines. 

As a gun owner, Figliola expressed his support for the Second Amendment and added that the majority of gun owners act safely.

“We have some very insane people that are committing these horrendous and heinous crimes,” he said. “I don’t believe we should be throwing the baby out with the bath water.”

Figliola said the issue of mass shootings is a matter of enforcement rather than additional restrictions. To curb mass violence, he believes that the laws on the books should be enforced and that illegal guns should be targeted and removed.

“The issue here is that we are not enforcing the laws,” he said. “When you go to places like Buffalo and that horrendous mass shooting — a shooting of 10 people — there were all these laws that the Democrats and Kathy Hochul, our governor, put in place and they said that that was supposed to stop mass shootings and it didn’t.” He also advocated for adding armed security in schools and for “a solution with mental health, but not going after law-abiding gun owners.”

LaLota said that the majority of gun crimes are committed with unregistered firearms. Like Figliola, he favored tougher enforcement of existing laws. Given his background, he suggests that he has a unique understanding and appreciation for responsible gun ownership.

“I’m a legal gun owner,” he said. “I grew up in a law enforcement family with a deep respect for the Second Amendment and for safely operating a firearm. I furthered that understanding as an officer in the military, where I learned to safely handle firearms.”

For LaLota, the problem of gun safety is closely tied to the issue of criminal justice reform. “In New York, we’re living in tough times with this bail reform law,” he said. “We have some folks out on the streets who should not be out on the streets.” He added, “It’s not a fact of not having enough laws. It’s a fact of not enforcing the laws that are on the books right now.”

Abortion

The recent Dobbs decision out of the U.S. Supreme Court, which overturned Roe v. Wade and Planned Parenthood v. Casey, has placed a cloud of uncertainty over the future of abortion access nationwide. When asked whether they would support legislation that would legalize abortion nationally, they each declined, opting instead to limit the existing abortion laws in the state.

“The recent Supreme Court decision, which gave the power back to the states and thereby the people, is good,” LaLota said. “This gives the maximum amount of power to we, the people, to hold the politicians accountable and have a policy that comports [with] their values.”

He referred to the existing abortion policies in New York as “radical,” suggesting that the state should modify its abortion laws to eliminate late-term abortions.

“We should celebrate life,” LaLota said, adding, “And the way that we celebrate life is by protecting it. I think that in New York, abortion should be on the ballot this November. We should ask every state assemblymember, every state senator and every candidate for governor: Would you support the repeal of the third trimester abortion provision?”

Figliola also supported the Dobbs decision. He argued that the decision-making power to regulate abortions should be in the hands of the people and their elected representatives rather than the Supreme Court.

“I believe that this current court got it right in giving it back to the states because the court should not be in a position to be legislating,” he said. “As a strict constitutionalist, it is the people who elect their representatives, petition their members of Congress and their state legislatures, and they choose what they want to vote on.”

Figliola favored drastic changes to existing abortion laws. “The reality is there shouldn’t be abortions at all,” he said. “On Long Island, between the ages of 18 and 24, we have a third of pregnancies that end in abortion. This is horrendous.” He added, “History is going to look back on us and they’re going to look very unkindly on us that we’re not choosing life — and not just the life of that child but the life of that mother and the hope and the amazing life that the two of them could live.”

Public health

The threat of COVID-19 remains a priority even two years after the height of the pandemic. Both candidates were asked whether they would favor mask mandates, quarantines or mandatory proof of vaccination for public events. In addition, they were asked to provide the steps that the federal government should take to promote the health of American citizens.

LaLota emphasized the importance of providing accurate information to the public while also empowering citizens to make their own health decisions.

“The federal government should allow people to have access to real, reliable information and people should be able to make decisions on their own,” he said. “I would be tremendously against any sort of federal law or federal mandate involving these sorts of health issues.”

Figliola condemned what he called “unconstitutional mandates,” which, according to him, have put people out of work. Regarding potential solutions, he suggests that the federal government begins to put together an endgame strategy for the postpandemic United States.

“I think that the pandemic, by and large, is over,” he said. “We’re now in the ‘endemic’ stages of things, and I think politicians want to find a way to control the people. They’re using the pandemic or whatever the next variant is to try to make people subservient.” He continued, “It’s people’s own individual rights to decide what they want to do with their body, with their children, with their health care — and we’re moving away from that.”

To watch the entire nearly one-hour debate, visit the SeaTv Southampton YouTube channel.

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

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

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

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

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

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

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

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

Raising awareness of monkeypox

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

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

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

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

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

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

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

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

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

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

Other viruses

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

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

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

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

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

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

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

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

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

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

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

A plea for proper vaccinations

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

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

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

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

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

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Monkeypox vaccines were made available at pop-up clinics on Fire Island. Stock photo

Amid an increase in cases of a virus caused primarily by close skin contact, Suffolk County started to provide vaccinations this week.

By appointment only, Suffolk County is administering 750 vaccinations to eligible people at pop-up clinics on Fire Island. Within under two hours, the county, with help from Northwell Health, had received requests for all of the available vaccines.

“It was heartwarming that so many people signed up for the vaccine right away in the at-risk community,” said Dr. David Galinkin, an infectious disease specialist at Port Jefferson-based St. Charles Hospital. People want to “stop this in its tracks.”

While monkeypox was discovered in 1958 and had its first reported cases in humans in 1970, the current limited outbreak is the first time health officials documented it spreading through person-to-person contact in the United States. Previous outbreaks involved a returning traveler from Africa or through contact with an infected animal.

As of the end of last week, Suffolk County had reported three cases of monkeypox.

About 98% of the cases in the country were reported among members of the gay and bisexual community of men who have sex with other men, Galinkin said.

A rare condition, monkeypox has symptoms including fever, headache, muscle aches, swollen lymph nodes, chills, exhaustion, and a rash that looks like pimples or blisters on people’s faces, inside their mouths and on hands, feet, chest
and genitals.

People who contract monkeypox can have symptoms that last for two to four weeks.

“While the current global outbreak appears to have heavily impacted [men who have sex with men], it is important to understand that this is a disease that is transmitted by intimate prolonged contact with an infected individual,” Dr. Susan Donelan, medical director of Healthcare Epidemiology at Stony Brook Medicine, explained in an email. 

Medical officials pointed out that monkeypox doesn’t present the same threat to public health as COVID-19, which can be spread by breathing in air contaminated with viral particles.

Health officials, however, are urging people to take steps to protect themselves against a virus that can be uncomfortable and that can spread to others through various levels of contact.

“Most important to understand is that monkeypox is not a sexually transmitted disease,” Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health. “It is sufficient to touch an active lesion to be exposed.”

Prevention

The Centers for Disease Control and Prevention has considerable information on a website dedicated to monkeypox, which people can access at the link: www.cdc.gov/poxvirus/monkeypox

The CDC urges people to avoid close skin to skin contact with the rash. The center also recommends that people not kiss, hug, cuddle or have sex with someone who has the virus.

People should not handle or touch the bedding, towels or clothing of someone who is sick. To protect themselves, those who might have come in contact with a person who has monkeypox should wash their hands with soap and water or use an alcohol-based hand sanitizer.

Adding to the list of concerns during pregnancy, women can spread the virus to their fetus through the placenta.

Unlike COVID, people who do not have monkeypox symptoms can’t spread the virus to others.

Vaccinations

The most commonly used vaccinations involve two shots that are 28 days apart. Like vaccines for COVID, the optimal protection is expected two weeks after the second dose, Donelan said.

The CDC recommends that people who are close personal contacts of those with the virus get the vaccine. The center also urges those who may have been at increased risk of exposure, through laboratory testing, to consider receiving shots as well.

The CDC suggested that people get the vaccines within four days from the date of exposure for the best chance to avoid developing the disease.

Vaccines given between four and 14 days after exposure may reduce symptoms but may not prevent the disease.

Combining the vaccination with self-isolation and other measures can control outbreaks and prevent further transmission of the virus, the CDC explained.

Monkeypox vaccines aren’t as readily available as those for COVID.

“As vaccine production ramps up, we will expand our operations to ensure that anyone who wants to get vaccinated is able to,” County Executive Steve Bellone (D) said in a statement.

Dr. Gregson Pigott, county health commissioner, also explained in a statement that he encourages “those who may be at risk to get the vaccine and, in the meantime, be cautious with your intimate relations.”

COVID-19 update

COVID, meanwhile, continues to spread through Suffolk County, despite the warmer weather and the greater opportunity for outdoor interactions.

As of July 10, the seven-day average for positive tests was 9.3%, according to the New York State Department of Health. That is up from 7.5% on a seven-day average in June.

“The incidence of COVID has increased in the last few weeks in Suffolk County,” wrote Popp, of Huntington Hospital, which, earlier this week, had 15 COVID patients at the hospital.

The high current positive rate is “likely due to the fact that most COVID-related prevention measures have been discontinued” including masks and social distancing and the current omicron subvariants are also more transmissible, Popp said.

As of July 11, Stony brook University Hospital had 52 positive COVID inpatients, compared with 39 on June 11, according to Stony Brook Medicine officials.

Over the past weekend, Galinkin admitted more patients with COVID at St. Charles Hospital than he had in months.

“It seems to be on the rebound,” he said, as the BA-5 strain is the “most contagious strain we’ve seen,” he said. He expects the numbers to continue to rise.

COVID symptoms from BA-4 and BA-5, which are the dominant variants in Suffolk County are milder than previous types. Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Disease at Stony Brook Children’s Hospital, wrote in an email. The hospital is also seeing much less frequent loss of smell or taste with the current variant.

Nachman is concerned about possible increased rates of infection in the fall and winter.

“Overlying that concern is the heightened risk of our routine, formerly seasonal viruses co-occurring with COVID leading to more illness visits and hospitalizations, especially among our most vulnerable populations,” Nachman said in an email.

Galinkin said the higher level of COVID infections underscores the importance of vaccinations.

“It’s our best defense against this,” he said. “There’s talk of a new and improved vaccine coming out in the fall” that will provide protection against omicron variants. “Hopefully, people will take advantage of that.”

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Sechrist model chamber for hyperbaric oxygen therapy. Photo courtesy Renee Novelle

Port Jefferson’s St. Charles Hospital will open its new Center for Hyperbaric Medicine & Wound Healing on July 18, as the hospital seeks to help people with chronic, nonhealing wounds.

The center, which will be located on the second floor of the hospital, will include two hyperbaric chambers that provide 100% pure oxygen under pressurized conditions and will have four examining rooms.

The chamber “provides patients with the opportunity to properly oxygenate their blood, which will increase wound healing and wound-healing time,” said Jason Foeppel, a registered nurse and program director for this new service.

Potential patients will be eligible for this treatment when they have wounds that fail to heal after other treatments for 30 days or more.

Residents with circulatory challenges or who have diabetes can struggle with a wound that not only doesn’t heal, but can cause other health problems as well.

More oxygen in people’s red blood cells promotes wound healing and prevents infection.

The treatment “goes hand in hand to deliver aid to the body’s immune system and to promote a healing environment,” Foeppel said.

Nicholas Dominici, RestorixHealth regional director of Clinical Operations; Ronald Weingartner, chief operating officer, St. Charles Hospital; Jim O’Connor, president, St. Charles Hospital; and Jason Foeppel, program director. Photo courtesy Renee Novelle

St. Charles is partnering with RestorixHealth in this wound healing effort. A national chain, RestorixHealth has created similar wound healing partnerships with other health care facilities in all 50 states.

The new wound healing center at St. Charles is one of several others on Long Island, amid an increased demand for these kinds of services.

Partnering with Healogics, Huntington Hospital opened a hyperbaric chamber and wound healing center in May 2021. Stony Brook Southampton Hospital also has a wound care center.

“There’s a great need for this in our community,” said John Kutzma, program director at the Huntington Hospital center. “We know that there are 7 million Americans living with chronic wounds,” many of whom did not receive necessary medical attention during the worst of the pandemic, as people avoided doctors and hospitals.

Concerns about contracting COVID-19 not only kept people from receiving necessary treatment, but also may have caused nonhealing wounds to deteriorate for people who contracted the virus.

Although Kutzma hasn’t read any scientific studies, he said that, anecdotally, “We’ve had patients that had COVID whose wounds haven’t healed as quickly as non-COVID patients.”

Patients at the Huntington Hospital center range in age from 15 to 100, Kutzma said. People with diabetes constitute about one-third of the patients.

Treatment plan

For the hyperbaric chamber to have the greatest chance of success, patients typically need daily treatments that last between one and a half to two hours, five days a week for four to six weeks. While the time commitment is significant, Foeppel said it has proven effective in wound healing studies.

“We pitch it as an antibiotic treatment,” he said. “You want to complete that full cycle to ensure the body has enough time to complete the healing process.”

Kutzma said Huntington Hospital reviews the treatment plan with new patients.

In following the extensive treatment protocol to its conclusion, he said, “The alternative is to live with this very painful, chronic wound that may lead to amputation.” Given the potential dire alternative, Huntington Hospital doesn’t “have a problem getting that kind of commitment.”

While the treatment has proven effective for many patients, not everyone is medically eligible for the hyperbaric chamber.

Colin Martin, safety director. Photo courtesy Renee Novelle

Some chemotherapy drugs are contraindicators for hyperbaric oxygen treatments. Those patients may have other options, such as skin grafts, extra antibiotics or additional visits with physicians for debridement, which involves removing dead, damaged or infected tissue.

“We invite patients to come in, go through the checklist and see what their plan of attack” includes, Foeppel said.

The cost of the hyperbaric treatment for eligible conditions is generally covered by most health insurance plans, including Medicaid and Medicare, he said. 

The two hyperbaric chambers at St. Charles can treat eight to 10 patients in a day.

Aside from the cost and eligibility, patients who have this treatment frequently ask what they can do during their treatments. The center has a TV that can play movies or people can listen to music.

“We don’t expect you to sit there like in an MRI,” Foeppel said.

As for complaints, patients sometimes say they have pressure in their ears, the way they would if they ascend or descend in an airplane. The center urges people to hold their nose and blow or to do other things to relieve that pressure.

Foeppel encourages patients to use the restroom before the treatment, which is more effective when people don’t interrupt their time in the chamber.

Prospective patients don’t need a referral and can call the St. Charles center at 631-465-2950 to schedule an appointment.

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Kasumi Layne-Stasik & Luke Florio
Emilia Guzzetta & Logan Shaffer
Carley Davidson and Ryan Parmegiani
Anthony Evangelista and date
Olivia Alvarez and Kyle Scandale
Madison Valenta and date

The Port Jefferson senior prom, a community tradition dating back over half a century, returned on Tuesday, June 28, after two years of disruption caused by the COVID-19 pandemic.

Although the event itself was held off premises at The Meadow Club in Port Jefferson Station, a red carpet celebration was successfully conducted at the school, viewed by a sizable turnout of family, friends and community members.

Couples arrived in a wide array of vehicles — fire trucks, sports cars, hot rods, just to name a few. Spectators cheered and honored the students as they arrived and walked up the steps of the high school for what may have been the last time as high school students.

This year, nearly 100 guests attended the prom festivities. This local tradition is alive and well once more.

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