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Wedding. Pixabay photo

By Daniel Dunaief

Daniel Dunaief

We’re finally here.

These poor couples have had to wait for days, months and years to tie the knot in front of family and friends. It’s such a relief that we can all gather again, celebrating the love that binds two people forever and that may, if it hasn’t already, lead to children.

It seems that the list of dos and don’ts for weddings has changed, just as so many other parts of modern reality have altered the way we go about our lives.

Here are a few of the dos and don’ts, starting with the don’ts.

— Cough. Ever. If you have to cough, swallow it or make it sound like a strange laugh. No one wants to hear a cough, least of all at a wedding. Go outside to cough. Cough in the car. Cough into your hand like you’re saying something private and being discrete. Go to the edge of the parking lot and cough.

— Chew with your mouth open. No one wants to see the food you’re eating, especially not in the third year of COVID-19.

—  Point to the food and say how much better you could make it. Look, we know that you’ve lost a step on your social graces from being home so often. We know that you’ve spent a great deal of time cooking meals to your satisfaction. We know that you are a great admirer of your own food, your own voice, and your own way of doing things. Appreciate that someone else has made the food and will clean it up and that they do things differently than you do. You can have food you know you love as soon as you walk back into your fortress of solitude.

— Talk about politics. You’re not going to convince anyone who doesn’t agree with you already of your views. So, why bring it up? This isn’t the time to try to make a reasoned argument with relatives who only share genes and nothing else. Smile if they bring something up you find disagreeable.

— Complain about the weather. The bride, groom and the extended family have no control over the weather. If it’s too hot, get a drink. If it’s too cold, shift back and forth from one foot to the other or bring a sweater. The weather is either perfect, dramatic, lovely or dynamic.

— Talk about your own wedding. If people were there, they remember. If not, they don’t need you to compare what’s going on to what you did. Your wedding may have been lovely, but you’re not there right now.

— Point to someone else’s mask and ask them why they’re wearing it. Do whatever is comfortable for you. Don’t tell anyone else what to do because, well, that doesn’t work and it gets people angry. They do their thing, you do yours.

— Binge watch shows while you’re waiting for the ceremony to start. Yes, the invitation said the party would start at 7 p.m. and it’s now 7:18 p.m. So what? You’re there to celebrate other people and to witness this lovely moment. Netflix and other shows can wait. Live your life.

— Show pictures of your pet. Many of us added dogs, cats and fish, particularly during the pandemic.

Okay, so, here is a short list of dos:

— Give other people a chance to talk. Silence, periodically, is okay. You don’t need to fill every quiet moment, if there are any, with your opinions, thoughts and experiences.

— Ask someone to dance who seems eager for a partner. Grab your mother-in-law, your brother-in-law, or your something-in-law by the hand, lead him or her to the floor, smile, and appreciate the chance to dance.

— Remember that you won’t have to see many of these people until the next blessed event, whenever that is.

— Thank the bride, groom and their families for a lovely event. Even if you hated it, you’ve got some good stories to share and you gave your wonderful pets a short break from you.

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File photo

Even as the newer omicron subvariant of COVID-19 continues to spread throughout Long Island, hospitalizations and infections have been lower.

Hospitalizations, which had risen to 490 in mid-May from about 130 in early April, have been “slowly declining for the past week or two,” according to Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Service.

Area health care professionals suggested that the severity of symptoms also had eased up.

“COVID hospitalization rates are lower than in prior COVID waves,” Dr. Adrian Popp, chair of infection control at Huntington Hospital, explained in an email. Most of the patients have mild to moderate illnesses, although Huntington Hospital still does have some severe cases and/or a COVID-related death.

The average number of positive tests per 100,000 people in Suffolk County has declined from recent peaks. As of June 3, the 7-day average number of positive PCR and rapid tests per 100,000 people was 33, which is down from 52 on May 27 and 67.7 on May 20, according to New York State Department of Health data.

“If anything, Suffolk County rates are dropping,” said Dr. Michel Khlat, chief medical officer at St. Catherine of Siena in Smithtown. “We’re seeing a drop in inpatient cases.”

Many of the cases St. Catherine is finding are incidental, as the hospital tests for the virus in connection with other procedures.

At this point, the newer subvariant of omicron, called BA 2.12.1, accounted for 78.1% of the positive samples collected between May 22 and May 28 in New York, which is up from 593% in the prior two weeks, according to figures from the New York State Department of Health.

“Preliminary data suggest that Omicron may cause more mild disease, although some people may still have severe disease, need hospitalization, and could die from the infection with this variant,” Pigott added in an email.

Khlat suggested that hospitals aren’t tracking the type of variant. Even if they did, it wouldn’t alter the way they treated patients.

“It doesn’t make a difference” whether someone has one or another subtype of omicron, Khlat said. The treatment is identical.

Area doctors and medical care professionals continue to recommend that residents over 50 receive a second booster, particularly if they are immunocompromised or have other health complications.

“People over 50 should get the booster — it decreases the severity of COVID,” explained Popp.

Like much of the rest of the country, some Long Islanders have also contracted COVID more than once. The reinfection rate per 100,000 is currently 7.3%, according to New York State Department of Health figures.

“We are certainly seeing symptomatic COVID infections in persons who report having COVID at the beginning of this year or last year,” Dr. Susan Donelan, medical director of the Healthcare Epidemiology Department at Stony Brook Medicine, explained in an email. 

Popp explained that natural immunity from a COVID infection generally lasts about two to three months. Vaccine-related immunity generally lasts twice that duration, for about four to six months.

Doctors continue to urge caution during larger, poorly-ventilated indoor gatherings.

“Close crowds without masks, in an indoor setting with poor air flow, would be one version of a scenario with potential super-spreader potential,” Donelan explained.

Donelan said Stony Brook encouraged staff and patients to consider receiving boosters when they are eligible.

Popp believes wearing masks indoors while in a large gathering is a “reasonable” measure. That includes theaters, airplanes, buses and trains.

At Huntington Hospital, meetings continue to take place online.

“We decided as an organization that the risk of transmission is high enough to continue these measures,” Popp wrote. “We cannot afford to lose team members to COVID since it can negatively impact our operation.”

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Frank Melville Memorial Park. Photo by Heidi Sutton

By Leah S. Dunaief

Leah Dunaief

“Did you hear? Ted has come down with COVID and is in the ICU.” 

The words hit me in the gut.

This gentleman, with whom I serve on the board of directors of a local community group, has now been admitted to the local hospital. I sat next to him at the monthly meeting a couple of weeks ago. We exchanged pleasantries and made small talk. Neither of us wore masks. (Ted is probably in his 70s. I have not used his real name.)

Just when we think our virus-riven world may be returning to some semblance of normal, the pathogen acts up again. We seem to be going two steps forward and one step back as weeks and months go by. Yes, we have the vaccines, the boosters, the antiviral mediations and plenty of test kits now. But the contagion is not over, not even close, no matter how much we would like it to be and pretend it is. Neither is the fear that rises and falls. Those of us who have been spared thus far really don’t want to catch the disease, and those who have fallen ill don’t want to be the virus’s victim yet again.

It’s spring. Finally, spring, with the flowers and leaves, the emerald green and the birdsong. The comfortable temperatures allow us to sit out on our patios and back decks. Once again we can feel the joy spring brings. But it is also the third spring we are living under the black cloud of a pandemic.

Yes, we have learned a lot as a result. We have become more aware of the tiny miracles, the blossoming of each flower on the azalea bushes along the roadside as we walk, the warbling of the mockingbird stationed on the top of the tree beside our garage. The pace of life has slowed as a result of COVID, allowing us to become more appreciative, more mindful of our existence from moment to moment. Many of us have embraced remote work habits and thrive with more at-home time. These are silver linings.

But I can’t help mourning the loss of our before-virus lives. We haven’t been to a Broadway play in three spring seasons now. We have dropped our opera subscription. Contemplating a performance of Carmen at Lincoln Center, preceded by a scrumptious dinner in a Manhattan restaurant, makes me feel a bit dizzy with desire. 

I am still not relaxed enough, even with a mask, to indulge in my former existence. If we have been fortunate enough not to have lost a loved one to the disease, nonetheless, the virus has stolen from our lives, stolen not only events and spectacles but more painfully, time with family members and friends at those events. Time missed with those we are closest to, as we live our lives, cannot be made up. Our dear ones don’t live forever. Sometimes loved ones die, from the infection or other causes, and the hours we would have spent with them are lost to us forever.

Recently, researchers have interviewed thousands to answer the question, “How many close friends can one have?” The answer, the mean average and not counting family, is 3-6. Those friends are irreplaceable. When one dies, there isn’t another to step forward and take his or her place because such friendships take years to develop. I know. When I read that study, I immediately fell to counting my closest friends and came up with four. It would have been six but two have died, though not from COVID. I want to spend as much time with those who remain as possible, and I deeply resent the virus for getting in the way.

Friendship, we know, is important for good health. The opposite, isolation and loneliness, often the by-products of COVID, can be as harmful to us physically as smoking 15 cigarettes a day, according to Psychology Professor Julianne Holt-Lunstad, at Brigham Young University.

We must make every effort to stay connected to our family and friends.  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The coming fall and winter

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

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

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

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

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

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

Medical options

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

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

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

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

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

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

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

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

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

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Sheriff Toulon said he intends to address mental health and substance abuse during his second term. Photo from Toulon’s office

This week, TBR News Media had an exclusive interview with Suffolk County Sheriff Errol Toulon Jr. (D). During our conversation with the sheriff, he addressed his battles with cancer, the challenges of steering the sheriff’s department through a pandemic and his surprising place in the history of the New York Yankees.

Sheriff, what is your professional background and how did you land in the Suffolk County Sheriff’s Office?

I started my career in 1982 as a New York City correction officer and I worked with the New York City Department of Corrections for 22 years on the uniform side. From 1982 until 2004, I worked on various assignments in numerous jails throughout the department. We had almost 25,000 inmates in our city system back then. I worked in our emergency services unit for almost 10 years. I was a captain there and also a captain in our detectives unit for almost three years before I retired. I also worked in the compliance division toward the end of my career.

I had to leave because I had some health issues. I’m a two-time cancer survivor. Uniquely, after I was able to recover from my illnesses, I went back to school to finish my bachelor’s, master’s and I received a doctorate in education. I worked with County Executive [Steve] Bellone [D] as his assistant deputy county executive for public safety for almost two years, where I tell people that I truly got an understanding of the landscape of Suffolk County. Then, I returned back to New York City as the deputy commissioner of operations, overseeing almost all of the operational aspects of the department from 2014 until 2017. I then decided to run for sheriff in September of 2017.

How has your battle with cancer impacted both your outlook on life and the work that you do for Suffolk County?

One of the things that I realized as a two-time cancer survivor is that you never know what the person next to you — whether you’re on the ball field watching kids play or you’re in the movie theater or the supermarket — you don’t know if someone has health issues, financial issues, relationship issues. I think I have become a lot more sympathetic and also empathetic to the plights that people are going through.

Earlier in your career, you worked at Rikers Island. How has that experience shaped your later approach as county sheriff?

My father was a warden on Rikers Island for 36 years, starting off as a correction officer. I remember during one of the early conversations I had with him, I asked him about his employment. He said, ‘We rehabilitate men and women who are in jail.’ That kind of resonated with me throughout my career. 

When I became sheriff, I noticed that almost 85% of the men and women that are in our custody are returning back to our communities. In order to help them and to have less victims in our communities, while we have them within our custody why not try to provide them with the resources so that they can be successful when they return back to our communities?

What are some of the struggles that your department had encountered due to the COVID-19 pandemic and how did you attempt to overcome them?

When I was the deputy commissioner, we had to deal with the H1N1 and Ebola viruses. When we learned about COVID-19 in Washington state in 2020, we started preparing for the possibility of there being an outbreak. By the end of February, we had our plans set. We implemented them around the second week of March because the first [confirmed] case of COVID in New York state was March 1 and the first case in Suffolk County was March 8. By that second week of March, we started implementing measures of social distancing; we had masks that were mandated to be worn; we started doing temperature checks; and we told our staff that if they were not feeling well or had any of the signs of identified symptoms for COVID-19, that they should seek out their health care professionals. 

With the jails, we cleaned our facilities three to four times per day. Inmates were required to wear masks. We were able to “cell skip’’ our inmates, so instead of inmates being in cells 1, 2, 3, 4 and 5, they were in cells 1, 3, 5, 7 and 9. We did stop visits because, if you remember, [former] Governor [Andrew] Cuomo [D] had said that if we shut down visits for two weeks, we’d be OK. We did shut down our visits for any individuals coming in and for any service providers entering our jails. It proved to be somewhat successful, but we had to do it for longer than we anticipated. 

From March, when we first implemented those measures, until the beginning of December, we only had five inmates that had tested positive — and I should say, three tested positive in the jails, two came into the jail positive. I think we were very successful.

What we also did was that every newly admitted inmate had to go into a quarantine for 14 days while our medical staff checked up on them three or four times a day. We wanted to make sure that our new admission inmates weren’t exposing any inmates that had been in our custody with any potential virus. 

You were recently sworn in for a second term as sheriff. What is your vision for the next four years at the department?

There are three things that I’m working on.

Mental health and substance abuse seem to be the primary traits for the majority of the men and women not only in our custody but throughout the nation’s prisons and jails. We’re working very hard to understand those two components because we want to be able to help those men and women, and even those that are not in jail — maybe there’s no criminal activity in their lifestyles, but they’re still suffering. 

We want to see what we can do, working with various community partners and service providers to look more holistically and see what’s going on. We do understand, even with some of our youth, who we are learning may have adverse childhood experiences, not only are they experiencing mental health and substance abuse in the home, but there are also traumatic issues, domestic violence issues and socioeconomic challenges. Those are the things we intend to focus on.

We’re also looking to create the first network of information sharing for jails and prisons throughout the United States. We think this will be very beneficial. We know that most police departments are sharing information with each other, but jails and prisons throughout the country are not. We want to tap into that resource because if we learn of different trends that are occurring, we can also alert our law enforcement partners to these things that are occurring, specifically in the jails and prisons throughout our region and our country. 

Your office has donated bulletproof vests to the people of Ukraine. What are some of the other philanthropic initiatives that your office has been part of to benefit both Suffolk County and the greater global community?

That was a start by donating those decommissioned vests, but one of the things we are embarking on is that the Suffolk County Sheriff’s Office is now an advisory component to a sheriff’s foundation. This is not run by the Sheriff’s Office, but by a group of individuals. They’re a 501(c)(3) and their goal is to have fundraising events. We do so much in the community that they want to assist us in really helping these kids that are having certain issues. Whether it is donating school supplies or the various community events that we want to do, we want to strengthen the bond between the community and the Suffolk County Sheriff’s Office.

Also, we really want to engage our youth because they are the ones that we want to make sure are on the right path, that they look at law enforcement as a positive role model, and that they maybe even want to come join our forces and work at the Suffolk County Sheriff’s Office.

You are the first African American elected as Suffolk County sheriff. What does that distinction mean to you?

To me, and I know that’s something that has been said to me a lot, my first goal is to be the best sheriff possible, regardless of my race. I do realize that being the first African American not only as sheriff, but the first African American elected to a nonjudicial county-wide position on Long Island, Nassau or Suffolk, it’s something that I’m very cognizant of wherever and whenever I go somewhere. 

I know there are a lot of people looking at me, some favorably and some unfavorably. I think I need to be who I am and not necessarily who people perceive due to the color of my skin. 

Baseball season is now underway and I have learned that you also occupy a place in the history of the New York Yankees. Could you elaborate on this?

Yes. I was fortunate enough in 1979 and 1980 to be a bat boy with the New York Yankees. They had just come off of back-to-back World Series championships in 1977 and 1978. Tragically, in 1979 our captain, Thurman Munson, was killed in a plane crash and we fell short of making the playoffs that year. Subsequently, in 1980 we did make the playoffs, but we lost three straight to the Kansas City Royals. In the third game, I was the ball boy down the right field line watching George Brett hit a three-run homer off of Goose Gossage, which went into the upper deck. I realized then that my career as a bat boy had quickly come to an end. 

What are your thoughts on Aaron Judge’s contract fiasco? 

I hope they do sign him. I think he’s proven to be not only a great ballplayer when he’s not injured, but more importantly a great role model. Mr. [Joe] DiMaggio and Mr. [George] Steinbrenner — both of whom I was fortunate enough to meet and speak with — would say that he is the type of person they would want to be a Yankee for his entire career, very similar to Derek Jeter.

Sheriff, thank you for taking this interview. Is there anything else that you would like to say to our local readers?

Yes. I firmly believe that the Suffolk County Sheriff’s Office is changing the paradigm of criminal justice, not just in Suffolk County but throughout New York state. We’re continuing to look for partners, both from the governmental side but also the community side, to make sure that we are not only able to engage but also help those that need us. That’s why we’re here. We’re really here to help our community.

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During the height of the pandemic, a COVID-19 drive-thru testing area was set up in the South P Lot of Stony Brook University. Photo by Stony Brook Medicine

This week marked two years after the World Health Organization declared COVID-19 a pandemic, leading to the shutdown of schools, the closing of businesses, a surge in emergency room visits, and a desperate search for treatments to a new disease that was sickening and killing people around the world.

Pastor Doug Jansson, below, of Living Word Church in Hauppauge hugs his family while in SBU hospital for COVID-19. Photo from Stony Brook Medicine

For health care providers, life two years after the pandemic has dramatically improved from those first few days when medical professionals had far more questions than answers.

“The cloud that was hanging over our heads seems to have disbursed,” said Dr. Sunil Dhuper, chief medical officer at Port Jefferson’s St. Charles Hospital. “I feel a lot more optimistic now.”

Indeed, Suffolk County officials tracked a host of numbers throughout the pandemic, which carried different meanings at different times. In 2020, state officials considered a 5% positive testing rate as a potential warning sign to consider closing schools. Entering another phase of reopening businesses required that hospitals have at least 30% of their hospital beds available.

Those numbers, fortunately, have declined dramatically, with the current positive seven day testing rate at 1.5% for Suffolk County as of March 15 and 35% of hospital beds available, according to the New York State Department of Health.

Lessons learned

Amid much more manageable levels of COVID-19, health care officials reflected on the last two years.

For Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health, the “most important lesson we have learned is that we can never lose hope,” he said in an email.

Despite an initial United States response to the pandemic that Popp described as disorganized and confusing, he said “communities got together fast, local leaders took charge and, I think, we did our best under the circumstances.”

Carol Gomes, chief executive officer for Stony Brook University Hospital, suggested that one of the biggest lessons was to remain flexible, with the “ability to pivot into paradigm shifts that were unimaginable,” she wrote in an email.

She described how most good business practices suggest a just-in-time inventory, which is efficient and cost effective.

“During the pandemic, when the national supply chain was considerably weakened, we shifted to an entirely different model and now focus on stockpiling key supplies to ensure continuity of services,” Gomes wrote in an email.

Stony Brook Hospital has dedicated more space to ensure the availability of supplies by securing additional warehouse facilities, Gomes said.

Dhuper said a high level of coordination and cooperation in health care created the ability to “work wonders. A classic example of that is the mRNA COVID-19 vaccines. I think it has been a phenomenal accomplishment and a true game changer,” Dhuper said.

Signage outside of Stony Brook University Hospital. Photo from Stony Brook Medicine

Low point

Amid a series of challenges over the last two years, health care professionals also described some of the low points.

Popp recalled April of 2020, when COVID hit one of the nursing homes in the community. Of the 50 elderly residents under his care, 24 died in the span of two weeks. During this time, the hospital couldn’t even test for COVID. Popp described the losses as “heartbreaking.”

Dhuper, meanwhile, pointed to the roller coaster created by variants that brought concerns about infections and sicknesses back even as vaccinations seemed to create a viral firewall.

The delta variant followed by omicron “eroded confidence” in the viral response, as millions of people contracted variants that were more infectious than the initial Wuhan strain.

Monoclonal antibodies were also not as effective against these strains, which was “another blow,” Dhuper said. “Everything seemed like there was no end in sight and we were not going to come out of it” any time soon.

Message from 2020

If he could go back in time and provide advice to health care providers and the public in the early stages of the pandemic, Dhuper said he would encourage more mask wearing, particularly before vaccines became available.

“The mask was the only guaranteed protection in the absence of any medications,” Dhuper said. “That message was not very well delivered. Hand washing was good, but masks definitely helped.”

Gomes would urge the 2020 version of herself to remain on the same path traveled, which is to focus on the “safety and well being of our community, including our staff, faculty, patients and community at large,” she explained in an email. “What has worked well in the past may not necessarily help with a new crisis. Flexibility is key.”

Next steps

Recognizing the burden COVID-19 placed on health care providers, area hospitals have focused resources on the mental health strain.

Stony Brook has “significantly expanded its resources to provide support and assistance for health care staff,” Gomes explained. Resilience at Stony Brook is a special location within the hospital dedicated for staff and faculty that includes pet therapy, aromatherapy, massage chairs, counseling services, mindfulness and meditation classes, among other options.

Stony Brook also has a crisis management intervention team to support staff and faculty.

Outside the clinical setting, Dr. Adam Gonzalez, director of the Mind-Body Clinical Research Center and assistant professor of Psychiatry at the Renaissance School of Medicine at Stony Brook University, said several studies have shown a rise in anxiety and depression across the country and increases in suicide ideation for sub-groups.

Stony Brook Medicine launched depression screening throughout its practices to identify those in need of mental health care.

Positive signs

Health care providers appreciated the support they received from the community and the collaborative spirit that strengthened the medical community.

“We functioned as a team often working with health care providers that were not our usual team members,” Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, explained in an email. “It was not uncommon to see adult and pediatric physicians covering care of COVID-infected patients or working with residents across the spectrum of specialties making rounds together.”

For many health care workers, including Popp, the support from the community for health care workers was helpful and inspiring.

“I saw people and businesses alike help frontline workers in any way they could, making masks, bringing in food to the hospital, helping quarantined people with food shopping,” Dr. Popp wrote in an email.

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Jose M. Adrover and Mikala Egeblad. Photo by Lijuan Sun

By Daniel Dunaief

Cold Spring Harbor Laboratory Professor Mikala Egeblad thought she saw something familiar at the beginning of the pandemic.

Mikala Egeblad. Photo from CSHL

Egeblad has focused on the way the immune system’s defenses can exacerbate cancer and other diseases. Specifically, she studies the way a type of white blood cell produces an abundance of neutrophil extracellular traps or NETs that can break down diseased and healthy cells indiscriminately. She thought potentially high concentrations of these NETs could have been playing a role in the worst cases of COVID.

“We got the idea that NETs were involved in COVID-19 from the early reports from China and Italy” that described how the sickest patients had severe lung damage, clotting events and damage to their kidneys, which was what she’d expect from overactive NETs, Egeblad explained in an email.

Recently, she, her post doctoral researcher Jose M. Adrover and collaborators at Weill Cornell Medical College and the Icahn School of Medicine at Mt. Sinai proved that this hypothesis had merit. They showed in hamsters infected with COVID and in mice with acute lung injuries that disabling these NETs improved the health of these rodents, which strongly suggested that NETs are playing a role in COVID-19.

“It was very exciting to go from forming a hypothesis to showing it was correct in the context of a complete new disease and within a relatively short time period,” Egeblad wrote.

Egeblad, Andover and their collaborators recently published their work in the Journal of Clinical Investigation Insight.

Importantly, reducing the NETs did not alter how much virus was in the lungs of the hamsters, which suggests that reducing NETs didn’t weaken the immune system’s response to the virus.

Additional experiments would be necessary to prove this is true for people battling the worst symptoms of COVID-19, Egeblad added.

While the research is in the early stages, it advances the understanding of the importance of NETs and offers a potential approach to treating COVID-19.

An unexpected direction

Jose Adrover. Photo from CSHL

When Adrover arrived from Spain, where he had earned his PhD from the Universidad Complutense de Madrid and had conducted research as a post doctoral fellow at the Spanish Center for Cardiovascular Research in March of 2020, he expected to do immune-related cancer research.

Within weeks, however, the world changed. Like other researchers at CSHL and around the world, Egeblad and Adrover redirected their efforts towards combating COVID.

Egeblad and Andover “were thinking about the virus and what was going on and we thought about trying to do something,” Adrover said. 

Egeblad and Adrover weren’t trying to fight the virus but rather the danger from overactive NETs in the immune system.

Finding an approved drug

Even though they were searching for a way to calm an immune system responding to a new threat, Egeblad and Adrover hoped to find a drug that was already approved.

After all, the process of developing a drug, testing its safety, and getting Food and Drug Administration approval is costly and time-consuming. 

That’s where Juliane Daßler-Plenker, also a postdoctoral fellow in Egeblad’s lab, came in. Daßler-Plenker conducted a literature search and found disulfiram, a drug approved in the 1950’s to treat alcohol use disorder. Specifically, she found a preprint reporting that disulfuram can target a key molecule in macrophages, which are another immune cell. Since the researchers knew this was important for the formation of NETs, Daßler-Plenker proposed that the lab test it.

Working with Weill Cornell Medical College and the Icahn School of Medicine at Mt. Sinai, Adrover explored the effect of disulfiram, among several other possible treatments, on NET production.

Using purified neutrophils from mice and from humans, Adrover discovered that disulfiram was the most effective treatment to block the formation of NETs.

He, Assistant Professor Robert Schwartz’s staff at Weill Cornell and Professor Benjamin tenOever at Mt. Sinai tried disulfiram on hamsters infected with SARS-Cov-2. The drug blocked net production and reduced lung injury.

The two experiments were “useful in my opinion as it strengthens our results, since we blocked NETs and injury in two independent models, one of infection and the other of sterile injury,” Adrover said. “Disulfuram worked in both models.”

More work needed

While encouraged by the results, Egeblad cautioned that this work started before the availability of vaccines. The lab is currently investigating how neutrophils in vaccinated people respond to COVID-19.

Still, this research offered potential promise for additional work on NETs with some COVID patients and with people whose battles with other diseases could involve some of the same immune-triggered damage.

“Beyond COVID, we are thinking about whether it would be possible to use disulfiram for acute respiratory distress syndrome,” Egeblad said. She thinks the research community has focused more attention on NETs.

“A lot more clinicians are aware of NETs and NETs’ role in diseases, COVID-19 and beyond,” she said. Researchers have developed an “appreciation that they are an important part of the immune response and inflammatory response.”

While researchers currently have methods to test the concentration of NETs in the blood, these tests are not standardized yet for routine clinical use. Egeblad is “sensing that there is more interest in figuring out how and when to target NETs” among companies hoping to discover treatments for COVID and other diseases.

The CSHL researcher said the initial race to gather information has proven that NETs are a potentially important target. Down the road, additional research will address a wide range of questions, including what causes some patients to develop different levels of NETs in response to infections.

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Metro photo

As COVID-19 infection rates and deaths begin to decline, more attention to the pandemic’s effect on mental health is needed.

In “Amid declining COVID infections, worry about mental health remains” by Daniel Dunaief featured in the Feb. 24 TBR News Media newspapers and online, Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services, cited two Centers of Disease Control and Prevention studies.

The research shows that the children’s mental health crisis alone has gotten worse during the pandemic. The CDC’s Household Pulse Survey also shows 39.2% of people nationally aged 18 to 29 had indicators of anxiety or depression between Jan. 26 and Feb. 7 of this year. As the group members increased in age, the percentage decreased, with 9.3% of those 80 years and above reporting mental health issues.

We have heard many times throughout the pandemic that the isolation and precautions needed to slow down the infection rate could increase anxiety and depression in people. At a press conference last week, held at the Smithtown Senior Center, elected officials discussed the importance of seniors returning to the activities they love and spending time with family and friends, which is vital for their overall well-being.

People need interactions with others to stay healthy and have someone to remind them that they are a good person and that the world is a better place with them in it. As we begin to remove our masks, it’s time to smile again and have conversations with those we encounter in our everyday lives.

Understandably, getting the virus under control during the height of the pandemic was a priority. Now, it’s more important than ever to talk about mental health and stop sweeping things under the carpet.

For most people, that could mean checking in with loved ones. Even if an in-person visit isn’t an option for some right now, a phone call or text message can make a difference.

While it was innovative and necessary to hold doctors’ visits, including those with psychiatrists and therapists, over Zoom during the pandemic, this is not the best option for everyone. Just as some students don’t do well with remote learning, many people don’t respond well to remote therapy.

Sometimes a person needs a one-on-one conversation face-to-face, not only with someone who isn’t judging them or doesn’t have an agenda, but also a professional who can see if they are making eye contact or fidgeting or not responding well to medication. Sometimes body language needs to be read to see if a patient is being truthful or just going through the motions.

While a conversation with a mental health professional is always a wise thing to do — whether in person or online — sometimes, for the real work to be done, it needs to be one-on-one in an office. So, if you need it, don’t hesitate to ask for an office visit. Most therapists are beginning to offer them again.

During the pandemic, people learned new ways of doing things to stay healthy, and some of those ways may be better. But meeting up with a friend and talking while eating or drinking coffee, or sitting on the couch in a therapist’s office — truly connecting — that can’t be beaten.

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Suffolk County Executive Steve Bellone, at podium, and Town of Smithtown Supervisor Ed Wehrheim at a press conference Feb. 25. Photo by Rita J. Egan

Suffolk County Executive Steve Bellone (D) and Smithtown Supervisor Ed Wehrheim (R) stopped by Smithtown’s senior citizens center to talk about COVID-19 and distribute at-home tests to center visitors Friday, Feb. 25.

Suffolk County Executive Steve Bellone talks with visitors at the senior citizen center. Photo by Rita J. Egan

Before the press conference, county Legislator Leslie Kennedy (R-Nesconset) began delivering the 10,000 at-home COVID-19 test kits received by the town courtesy of the county. The kits were distributed on the day of the press conference and Monday to local assisted living communities, faith-based and small food pantries and community centers in the greater township.

Bellone said he reached out to New York Gov. Kathy Hocul (D) for help with continuing aid to vulnerable populations. 

“This was the time to really begin the conversation about how we transition back to normal, to the stage where we are living with the virus, essentially the endemic stage of the virus, and you’re seeing that conversation happening now around the country, as well, which I think is very important,” Bellone said. “As we do that, as we move to that different stage of the virus and manage that risk moving forward, we do still need to be making sure we’re doing everything we can to provide the resources necessary to protect vulnerable populations, senior citizens, those who may have issues with immunity, etc. We need to make sure that things that we know work that are available that they are easily accessible and available to those residents.”

Suffolk officials have been working with various partners such as nonprofits and law enforcement agencies since the beginning of the year to distribute at-home tests, masks and hand sanitizer to the most vulnerable. Bellone said the county has distributed at this point over 200,000 test kits and expects over the next six months that Suffolk will be distributing several hundred thousand more test kits, focusing on the most vulnerable populations.

Bellone added that vaccines, testing and therapeutics have been making a difference.

The county supervisor thanked Wehrheim for his help during the pandemic.  

“Supervisor Wehrheim has been an example of the kind of leadership that you need in unprecedented times, and I truly appreciate his partnership and the work that we were able to do together during the pandemic,” Bellone said.

Wehrheim also thanked Bellone for helping the town ensure that no one went without essentials during the pandemic and for the county’s continued support, especially for those on fixed incomes.

“Now families can visit loved ones in nursing homes with easy access to at-home test kits,” Wehrheim said. “Our older seniors can come back to a great senior community and our great senior citizens department to enjoy socializing. Most importantly, we can get back to living again, safer.”

New phase

Bellone said Suffolk County is moving into a new phase of the pandemic. 

“We just recently went through what I would characterize as the second most impactful wave of this virus,” he said, adding the omicron wave’s variant infection and hospitalization rates were as high as at the beginning of the pandemic and the county once again saw double-digit deaths.

“We know that this pandemic has caused incalculable devastation, and there will be impacts that we’ll be dealing with for a long time to come, no doubt,” he said. “But, what is clear now is — I think a couple things — we’re moving into a different phase, and this virus is not going to go away. It is going to be here with us. It is something that we are going to be living with.”

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METRO photo

When people look back to spring 2020, they remember how the COVID-19 pandemic shut things down. Zoom became a regular form of communication, visits to grandparents were done in a drive-thru fashion and many people anxiously awaited their stimulus checks.

While those checks from the U.S. government were sent, some people needed the money more than others. 

Many people lost their jobs, their businesses and their livelihoods. In fact, according to the U.S. Bureau of Labor Statistics, in February 2020 — just before the pandemic hit the States — unemployment was at 3.5%. Just two months later, as the virus began to spread rapidly, unemployment rates skyrocketed to nearly 15%.

But what many people might not realize is how impacted the local arts were during this time. 

We as a society leaned on our first responders out in the trenches. We listened to our elected officials on the news every day hoping to hear something good. We shopped locally to help our business-owning neighbors. 

However, something that we all enjoy one way or another — the arts — was shattered and not much was being done to help our local artists, performers and creators. 

According to Johns Hopkins University research, as of December 2021, the percentage of job losses at nonprofit arts organizations remained more than three times worse than the average of all nonprofits. 

Artists/creatives were — and remain — among the most severely affected segment of the nation’s workforce. The arts are a formidable industry in the U.S. — $919.7 billion (pre-COVID) that supported 5.2 million jobs and represented 4.3% of the nation’s economy.

And now, nearing two years since the 2020 shutdowns, artists on Long Island are voicing how it felt. Many believe that significant relief funding was not given to the arts and related nonprofits despite the impact they have on Long Island’s economy.

Think about it. How many of us love to see a show at the local theater? How many of us hang artwork from nearby artists on our walls? How many of us enjoy live music as we dine at our favorite eateries? 

Those people had jobs, too. 

Sometimes we forget that the people working after a typical 9-to-5 shift are working, too. What some may call a hobby is a way of life for thousands of people.

We still have a way to go, and unfortunately COVID will haunt us for a very long time in more ways than one. But the next time you’re out to dinner with a friend, drop a tip in the guitar player’s case. Splurge on a drawing from a local artist and support your neighborhood theater. 

The arts helped us during the pandemic. We found solace in other people’s creations. Now it’s time to pay back the artists and show them how much they are needed, wanted and loved.

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