Steve Bellone at a recent press conference. Photo by Rita J. Egan
Suffolk County Executive Steve Bellone (D) announced on Oct. 20 that he tested positive for COVID-19.
“Today I tested positive for COVID-19 and will be following the recommended CDC protocols for fully vaccinated individuals,” he said. “I am experiencing mild symptoms at this point but otherwise feel in good health and spirits.”
The county executive had a reminder for residents.
“I hope this serves as a reminder to all residents that while we are making incredible progress in the war against COVID-19, we are not done just yet,” he said. “To that end, I encourage anyone who is eligible to receive their booster shot to do so.”
Amid a steady drumbeat of worry and anxiety, the last week produced several potential encouraging signs in the battle against COVID-19.
Pfizer recently applied for emergency use authorization for a vaccine for children who are five to 11 years old, a group that has returned to school but that hasn’t yet had access to any vaccines.
Pfizer will get early approval as “long as the [Food and Drug Administration] has enough data,” said Dr. Sunil Dhuper, chief medical officer at Port Jefferson’s St. Charles Hospital. “They’re going to get early approval.”
A vaccine would be a welcome defense for children who now constitute anywhere between 25% and 35% of infections, Dhuper said.
Vaccinations for those over the age of 12 have helped drive down an infection rate that had climbed toward the end of the summer.
In recent weeks, the percentage of positive cases in Suffolk County has continued to decline, with the seven-day average falling to 3.2% as of Oct. 10, according to data from the Suffolk County Department of Health.
While health officials and pharmacies continue to administer booster doses of the Pfizer BioNTech vaccine, Johnson & Johnson has applied for Emergency Use Authorization for a booster dose that enhances the immune response to the virus.
As of now, people who received J&J’s original vaccine are not eligible for the Pfizer BioNTech booster, according to Dr. Sritha Rajupet, director of Population Based Health Initiatives and director of the Post-COVID Health Clinic at Stony Brook Medicine,
Meanwhile, Merck recently produced a drug in pill form called Molnupiravir that reduced hospitalizations and death by 50% when taken within the first five to eight days of developing COVID symptoms.
The drug didn’t completely prevent hospitalizations or death but greatly reduced it, generating excitement in the health care community. Merck applied earlier this week for emergency use authorization for Molnupiravir.
“It’s a great study,” Dhuper said. “We are very delighted that there is going to be another alternative” treatment for patients.
Up to this point, hospitals, urgent care centers and doctors have not had access to an outpatient drug.
When given at the onset of symptoms, Molnupiravir acts like the flu drug Tamiflu, helping to reduce the symptoms and health challenges associated with COVID-19.
This medicine could help reduce hospitalizations, providing relief to patients and enabling hospitals to manage their resources better, Dhuper said.
Doctors remained cautiously optimistic about the ongoing battle against COVID-19. Dhuper added that the real challenge for the community would come within the next three to four weeks, during which time hospitals and count officials will watch carefully for any increase in infections in between when children return to schools and the FDA approves any vaccine for this age group.
Long haul issues
While health officials were pleased with the potential availability of additional medical tools to prevent or treat COVID-19, they said numerous residents continue to battle long haul COVID.
Described as persistent symptoms that can develop four to eight weeks after the initial symptoms, long haul COVID can include fatigue, brain fog, shortness of breath, palpitations and a wide range of other neurological discomforts.
Doctors said 10 to 35% of people who contract COVID can develop these longer-term symptoms.
Long haul COVID-19 remains a “big concern,” Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services, wrote in an email. “We remind people who remain unvaccinated that people of all ages have suffered from long-range symptoms” from the virus. “We don’t know yet if these symptoms will be limited or if they may develop into chronic life-long conditions. We will be looking at the literature to learn more.”
Dhuper said some of those with long-haul symptoms feel as if they are “continuously living with an illness, almost like a flu.”
Such extended discomfort has an extended impact on the quality of life.
Treatment of these long-haul symptoms “is tailored to the patient’s specific symptoms,” Stony Brook’s Rajupet described in an email. “Identifying the organ systems involved and the symptoms or autoimmune conditions that have manifested are essential to developing a treatment plan.”
Rajupet suggested that leading a healthy lifestyle, with balanced sleep, nutrition and exercise can help in recovery. Stony Brook encourages this approach not only in the management of long-haul symptoms, but also for a patient’s overall health.
Agood idea during this later stage of the pandemic is to have an at-home rapid COVID test, which indicates a result in 15 minutes. Sometimes you just don’t know whether it’s a simple cold that’s arrived and is making your throat sore, or if the situation is more dire and you need to seek help. Or perhaps you find that you have been exposed to someone who has now tested positive, and you want to check yourself accordingly. Or you are about to visit grandma and you want to be sure you are not carrying the pathogen to her.
Besides the personal value, the tests can be an important public health tool, although for the moment demand is high and they are hard to find. I was able to locate two tests at a local drug store by calling around. They can be purchased at pharmacies for anywhere from $10 to $40 a test. The following are available without a prescription, according to The New York Times article, “At-Home COVID Tests: Valuable if Used Right,” in the issue of Oct. 5, and written by Emily Anthes: Abbott BinaxNOW, the Ellume COVID-19 Home Test (although there was some issue with this one yesterday), and the Quidel QuickVue At-Home COVID-19 Test. The tests “detect small viral proteins, called antigens,” and they “require rubbing a shallow nasal swab inside your nostrils, and then exposing the swab to a few drops of chemicals,” as described by the article. OraSure also makes them, among many other companies rushing their products to market.
While the manufacturers’ tests are fairly simple, their directions have to be followed carefully in order to provide a correct answer. And while their results are correct 85% of the time, the tests can give a false negative if taken too soon after exposure. Further, the tests are more sensitive to people with symptoms, especially during the first week, and when people are most infectious and can be actively transmitting the virus, according to Anthes.
The successful detection rate goes up to 98% when the tests are used repeatedly, say every three days for screening. But again, those with symptoms may test immediately, while those who have been exposed to the virus should wait 3-5 days to let the antigens accumulate in the nose, if they are there, before testing. In the event of a positive result, people should take the usual precautions: isolation, monitoring symptoms and calling for medical help if necessary. They should also get a second test to confirm the result.
Rapid COVID-19 tests are for sale in grocery stores for one euro (a bit more than a dollar) in Germany, and in Britain a pack of seven are free. Policymakers around the world realized that rapid tests were a valuable public health aide. We here in the United States must make them available and more cheaply so that we can know who is infected, who is a carrier and where the outbreaks are. President Joe Biden (D) has recognized this need and is working to make the tests accessible and more affordable. He needs to make the rapid tests official public health tools rather than medical devices. That would only take an executive order. And it would allow global manufacturers of COVID-19 tests to enter our market and immediately increase our supply.
According to a piece on the Opinion page of The New York Times in the Oct. 2 issue, written by experts Michael Mina and Steven Phillips, “Past economic analyses predicted that a major government-funded rapid testing program that reached every American could add as much as $50 billion to the gross domestic product and save tens of thousands of lives or more,”
There is, happily, bipartisan support for making all this happen. Vaccination plus rapid testing would mean no more unnecessary isolations, no more missed holidays with families, no more randomly closed schools or businesses. We would, in effect, be able to live with the bug.
Dr. Sharon Nachman, chief of Division of Pediatric Infectious Diseases at the Renaissance School of Medicine at Stony Brook University. Photo from Stony Brook Medicine
Dr. Sunil Dhuper’s actions speak as loudly as his words.
The chief medical officer at Port Jefferson’s St. Charles Hospital is planning to get a booster for the COVID-19 vaccine this Thursday, after the Centers for Disease Control and Prevention authorized Friday, Sept. 24, the additional shot for a range of adults, including those in jobs that put them at an increased risk of exposure and transmission, such as frontline health care workers.
Earlier, the U.S. Food & Drug Administration announced Sept. 22 that “a single booster dose” was allowed “for certain populations” under the emergency use authorization, although the EUA “applies only to the Pfizer-BioNTech COVID-19 vaccine.”
Dhuper received his first vaccination in January and would like to raise his immunity.
“I am very eager to get the booster dose,” he said in an interview. “I reviewed scientific data from all over the world — from the United States, Israel, the United Kingdom — and I had reflected that, after six months after the second dose, it’s time to get a third dose.”
While St. Charles and other hospitals haven’t required a booster, Dhuper believes that state and national guidance will likely recommend it before too long.
“Over time, I do anticipate people may begin to get severe infections or get hospitalized” if they haven’t enhanced their immunity with a booster, he said. “It would be prudent to get the booster dose in the arms of those who are fully vaccinated.”
Stony Brook University Hospital is providing boosters to employees and to eligible members of the public.
Meanwhile, Northwell Health and Huntington Hospital are deliberating how to proceed and will announce a decision soon, according to Dr. Adrian Popp, chair of infection control at Huntington Hospital.
While boosters are available for education staff, agriculture and food workers, manufacturing workers, corrections workers, U.S. Postal Service employees, grocery store workers, public transit employees and a host of others, the overall infection rate in Suffolk County has stabilized over the past few weeks.
Decline in infections
As of Sept. 25, the seven-day average rate of positive tests in the county fell below 4% for the first time since Aug. 15, dropping to 3.9%, according to data from the New York State Department of Health.
“We think the numbers might have plateaued,” Dhuper said. That decline coincides with the increasing number of people who are vaccinated. In Suffolk as at Sept. 29, 1,043,478 people (70.7%) have received at least one dose and 950,058 (64.3%) are fully vaccinated, according to Covid Act Now. Anybody who is at least 12 years old is eligible to be vaccinated.
The number of COVID Patients from Huntington Hospital has fallen in the last month, dropping to 20 from about 30, according to Popp. Five patients are in the intensive care unit at the hospital with COVID.
Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Children’s Hospital, described the downward trend in the seven-day average as “great news,” but added that such an infection rate is “not close to where we need to be to say we have turned a corner.”
The current infected population includes children, as “more kids are getting infected,” she said, with children currently representing 25.7 percent of all new COVID cases nationwide.
With the FDA and CDC considering approving the emergency use authorization that provides one-third of the dosage of the adult shot for children ages 5 to 11, Nachman urged residents to vaccinate their children whenever the shot is available to them.
“There is no advantage to picking the right age or dose for a child,” she explained in an email. “If they are 12 now, get that dose. If they are 11 and 8 months [and the CDC approves the vaccine for younger children], don’t wait until they are 12 to get a different dose. Get the dose now that is available for that age.”
When younger children are eligible for the lower amount of the vaccine, Dhuper also urged them to get that lower dose, which he feels “offers a good level of protection for the foreseeable future.”
Nachman said she sees the issue of weight or age bands regularly in pediatrics.
“The take-home message is to not play any games and treat the child at the age or weight that they are now and not wait for them to be older or heavier,” she suggested.
As for the next month, Dhuper cautioned that the county may show another peak, particularly with the increase of indoor activities where the spread of the more transmissible Delta variant is more likely. At this point, concerns about the Mu variant, which originated in South America and was much more prevalent in the United States and in Suffolk County in June, has decreased.
“We were seeing 5% of the cases in New York state were Mu variants and the remaining were Delta,” Dhuper said.
Popp estimated that the Mu variant constitutes between 0.1% and 0.3% of cases.
The World Health Organization has urged wealthier nations like the United States not to administer boosters to their populations widely before the rest of the world has an opportunity to vaccinate their residents.
Dhuper said the United States has contributed 500 million doses to the rest of the world this year and plans to donate about 1.1 billion doses to the rest of the world in 2022.
“I hope that other upper and middle income nations can do the same, so we can get [the shots] in the arms of those who need them,” he said.
Popp urged people to recognize that COVID is a global disease.
“We in the U.S. will not be safe until the epidemic is cleared in other parts of the world as well,” he explained in an email. “I believe it is in our national interest to help other countries fight the COVID epidemic.”
Popp said the United States has plenty of vaccine, with enough for boosters and to vaccinate those who haven’t gotten a shot.
As the new school year begins, students will have to wear masks once again. File photo from Smithtown Central School District
What a difference a month, or two, makes.
The percent of positive tests in Suffolk County on Aug. 29 stood at 5.1% with a 4.7% positive seven-day average, according to data from the Suffolk County Department of Health.
That is considerably higher than just a month earlier, with a 3.2% positive testing rate on July 29 and a 2.7% rate on a seven-day average. The increase in infections for the county looks even more dramatic when compared with June 29, when positive tests were 0.2% and the seven day average was 0.4%.
“With the highly transmissible delta variant of SARS-CoV-2 [the virus that causes Covid-19] circulating, we are urging everyone who is eligible to get the COVID-19 vaccine as soon as possible,” Gregson Pigott, commissioner of the Suffolk County Department of Health Services, wrote in an email. “We also advise residents to wear masks when indoors in public.”
With students returning to school during the increase in positive tests, including those who are under 12 and ineligible to receive the vaccination, Pigott explained that he was concerned about the positive tests in the county.
Nationally, the spread of the Delta variant is so prevalent that the Director for the Centers for Disease Control and Prevention Rochelle Walensky at a White House briefing urged people who are unvaccinated not to travel during the Labor Day weekend.
While area hospitals aren’t seeing the same alarming surge towards capacity that they did last year, local health care facilities have had an uptick in patients who need medical attention.
“The increased community transmission is concerning as it is correlating with hospital rates also slowly rising,” Bettina Fries, chief of the Division of Infectious Diseases at Stony Brook Medicine, wrote in an email.
Meanwhile, most of the patients hospitalized at Huntington Hospital are younger, from children who are transferred to people in their 20s to 50s, explained Adrian Popp, chair of Infection Control at Huntington Hospital/ Northwell Health, in an email.
As schools in the area prepare to return to in-person learning, Renaissance School of Medicine at Stony Brook University has been coordinating with officials to prepare for a safe return to in-person learning.
“Stony Brook faculty are working with a diverse group of school districts in planning for the upcoming school year,” Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, explained in an email.
In recent weeks, Stony Brook Children’s Hospital has had few pediatric hospitalizations for COVID-19, with more pediatric positive cases in the outpatient setting.
Area hospitals including Stony Brook and Huntington Hospital continue to have strict guidelines in place for health care workers including social distancing, hand washing and the proper use of personal protective equipment.
Amid increasing discussion of the potential use of boosters, Stony Brook awaits “formal guidance and will continue to follow all DOH directives on vaccine administration,” Fries wrote.
Ida and Covid
Outside of Long Island, Hurricane Ida has the potential to increase the spread of the virus, as larger groups of people crowd into smaller spaces.
The hurricane “may become a super spreader event since vaccination rates in the South are low and people may crowd into shelters or at home indoors,” Popp explained. “I am concerned not only about the hospital capacity in Louisiana, but also of the impact the hurricane can have on hospital functioning.”
Popp cited a loss of power, lack of supplies, and the difficulty for ambulances trying to reach patients in flooded areas.
Obesity is an ongoing struggle for many in the United States. If you, like many, put on some extra pounds during the past 18 months, it’s even more concerning.
Obesity is a disease unto itself and is defined by a BMI (body mass index) of >30 kg/m2, but obesity can also be defined by excess body fat, which is more important than BMI.
Poor COVID-19 outcomes have been associated with obesity, especially in the U.S. In a study involving 5700 hospitalized COVID-19 patients in the NYC area, the most common comorbidities were obesity, high blood pressure and diabetes (1). Of those who were hospitalized, 41.7% were obese.
In a study in China, results showed that those who were overweight were 86 percent more likely to have severe COVID-19 pneumonia, and that percentage increases to 142 percent when obesity is reached (2).
In fact, one study’s authors suggested quarantining should be longer in obese patients because of the potential for prolonged viral shedding compared to those in the normal range for weight (3).
And though age is a risk factor for COVID-19, among those younger than 60 and obese, there is a two-times increased risk of being admitted to the hospital, according to a 3,615-patient study at NYU Langone Health (4).
While these studies do not test specifically for the more recent variants, I would expect the results are similar.
Why is risk for severe COVID-19 higher with obesity?
According to the prevailing theory, obesity may interfere with mechanical aspects of breathing, thus increasing airway resistance and make gas in exchange more difficult in the lung. It may also impede on lung volume by exerting pressure on the lungs and may involve weaker muscles necessary for respiration (5).
Why is excess fat moreimportant than BMI?
First, some who have elevated BMI may not have a significant amount of fat; they may actually have more innate muscle. More than 25 percent of my patient population is “solidly built,” which means they have greater muscle mass as well as too much excess fat. Visceral fat is the most important, since it’s the fat that lines the organs, including the lungs.
For another, fat cells have adipokines, specific cell communicators found in fat cells that communicate with other fat cells but also other systems such as the brain, immune system, muscles, and liver. Adipokines can be mediators of both inflammation and insulin resistance, according to an endocrinology study (6). In a study of over 4,000 patients with COVID-19, the author suggests that inflammation among obese patients may be an exacerbating factor for hospitalizations and severe illness (7).
If we defined obesity as being outside the normal fat range – normal ranges are roughly 11-22 percent for men and 22-34 percent for women – then close to 70 percent of Americans are obese.
Inflammation reduction and weight-loss combined
In a randomized controlled trial with 75 participants comparing a plant-based diet to a control diet, there was a greater than 14 lbs. weight reduction and roughly 10 lbs. fat reduction over a 14-week period (8). Of the weight lost, about 70 percent was excess fat. Remember, excess body fat, through adipokines, may be inflammatory and increase the risk of severe COVID-19.
The weight reduction with a plant-based approach may involve the increase in fiber, reduction in dietary fat and increased burning of calories after the meal, according to Physician’s Committee for Responsible Medicine (PCRM) (9).
You also want a diet that has been shown to reduce inflammation.
We recently published a study involving 16 patients from my clinical practice. It shows that those who ate a whole food plant-based LIFE (low inflammatory foods everyday) diet over a seven-day period had a significant decrease in inflammation measured by hsCRP (high sensitivity c-reactive protein). This occurred in those who completely changed their diets to the LIFE diet, but also occurred in those who simply added a greens and fruit-based smoothie daily to their existing diet (10).
In my practice, I have seen a number of patients lose a substantial amount of weight, but also body fat, over a short period. For instance, a 70-year-old male lost 19 lbs. of weight and 12 lbs. of body fat over a six-week period. His inflammation, which was very high to start, dropped substantially to the border of optimal levels, using hsCRP as the inflammation measurement. This patient and many others have seen tandem reductions in both weight and inflammation. To boot, this was a cardiac patient whose cardiologist had considered a stent, but later said he did not need it after reducing his inflammation.
If the continuing COVID-19 concerns do not convince you that losing excess fat is important, then consider that obesity contributes to, or is associated with, many other chronic diseases like cardiovascular disease, high blood pressure, and high cholesterol, which also contribute to severe COVID-19. Thus, there is an imperative to lose excess body fat.
References:
(1) JAMA. online April 22, 2020. (2) Clin Med (Lond). 2020 Jul; 20(4): e109–e113. (3) Acta Diabetol. 2020 Apr 5: 1–6. (4) Clin Infect Dis. 2020 Jul 28;71(15):896-897. (5) Chron. Respir. Dis. 5, 233–242 (2008). (6) Front Endocrinol (Lausanne). 2013; 4:71. (7) MedRxiv.com. (8) Nutr Diabetes. 2018; 8: 58. (9) Inter Journal of Disease Reversal and Prevention 2019;1:1. (10) Am J of Lifestyle Med. online Oct. 5, 2020.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
Maurizio Del Poeta in his laboratory at Stony Brook University. Photo by Antonella Rella
By Daniel Dunaief
Researchers at Stony Brook University, the University of Arizona and Wake Forest University School of Medicine in North Carolina may have found an enzyme that drives the worst COVID-19 symptoms. Secreted phospholipase A2 group IIA, or sPLA2-IIA may lead to severe symptoms and death, making this enzyme a potential therapeutic target.
P116, Maurizio DelPoeta, Microbiology
In an examination of plasma samples from 127 patients hospitalized at Stony Brook University Medical Center between January and July 2020 and a mix of 154 patient samples from Stony Brook and Banner University Medical Center in Tucson between January and November 2020, scientists including Distinguished Professor Maurizio Del Poeta of the Renaissance School of Medicine at Stony Brook University found that 63 percent of people with concentrations of the enzyme that were over 10 nanograms/ milliliter generally died. Most healthy people have circulating levels of the enzyme around 0.5 nanograms/ milliliter.
“It is possible that sPLA2 levels represent a tipping point and when it reaches a certain level, it is a point of no return,” said Del Poeta.
The collaborators involved in the study, which was published this week in the Journal of Clinical Investigation, were encouraged by the finding.
“This is exciting as it is leading to really novel connections for COVID-19,” Yusuf Hannun, Director of the Cancer Center at Stony Brook and a contributor to the research who participated in the discussion and data analysis, explained in an email. “It may lead to both diagnostics (for risk prediction) and therapeutics.”
Looking closely at the levels of sPLA2-IIA together with blood urea nitrogen, or BUN, which is a measure of the performance of the kidney, the researchers in this study found that the combination of the two measures predicted mortality with 78 percent accuracy.
“That is an opportunity to stratify patients to those where an inhibitor” to sPLA2-IIA could help patients, said Floyd Chilton, director of the University of Arizona Precision Nutrition and Wellness Initiative and senior author on the paper, said.
While they found a difference in the amount of the enzyme between healthier and sicker patients, the scientists recognize that this could reflect a correlation rather than a causation. The progression of the disease and the threat to people’s lives may come from other contributing factors that also intensify the severity of the illness.
“These studies do not establish causality at the moment, but the strength of the correlation and the known functions of this enzyme raise the possibility of participating in the pathology of the disease,” Del Poeta explained.
Floyd Chilton. Photo from University of Arizona
Indeed, Chilton has studied sPLA2-IIA for over three decades and has described some patterns in other diseases, including sepsis.
The enzyme performs an important role in fighting off bacterial infection by destroying microbial cell membranes. When the concentration of sPLA2-IIA rises high enough, however, it can threaten the health of the patient, as it can attack and destroy cells in organs including the kidney.
The enzyme “plays a critical role in host defense,” said Chilton. “These same systems can really turn on the host.”
In order to determine a causative link between sPLA2-IIA and the progression of the disease, Chilton, Del Poeta and others will need to increase their sample size.
“We’ve been very fortunate at getting individuals at some of the top global organizations… who have connected me with medical centers” that have a larger patient population, Chilton said. These executives may be able to expedite the process of expanding this study.
In the 1990’s, scientists studied an inhibitor that had the ability to act on the enzyme.
That effort had mixed results in phase 2 clinical trials.
“In 2005, the first phase of the phase 2 clinical trials were highly encouraging,” Chilton said. “It really inhibited mortality at 18 hours” by reducing severe sepsis. The second part of those tests, which used a slightly different protocol, failed.
While he’s not a clinical trials expert, Chilton is hopeful that researchers might find success with this same drug to treat COVID-19.
Only clinical trials would reveal whether inhibitors would work with COVID-19, scientists said.
As with many drugs, inhibitors of sPLA2-IIA have side effects.
By blocking the activity of these enzymes, “we do also decrease the production of arachidonic acid, which is a precursor of prostaglandins,” said Del Poeta. “In condition of hyperinflammation, this is a good thing, but prostaglandins are also important in a variety of cellular functions” including blood clots and starting labor.
Chilton pointed out that sPLA2-IIA is similar to the active enzyme in rattlesnake venom. It can bind to receptors at neuromuscular junctions and disable the function of these muscles, he explained.
In nature, some animals have co-evolved with snakes and are no longer susceptible to these toxins. Researchers don’t yet understand those processes.
While copying such evolutionary solutions is intriguing, Chilton said he and his collaborators are “much more interested in the inhibitors” that were taken through clinical trials in 2005 because that might present a quicker solution.
The research collaboration started with Chilton, who partnered with Arizona Assistant Research Professor Justin Snider. The first author on the paper, Snider earned his PhD at Stony Brook, where he knew Del Poeta well.
Snider “knew what a great researcher [Del Poeta] was. I also knew [Hannun] in a former life. We were both working on similar biochemistry 20 to 25 years ago,” Chilton said.
Chilton called the efforts of his Stony Brook collaborators, including Research Assistant Karen You, Research Associate Professor Chiara Luberto and Associate Professor Richard Kew,“heroic” and explained that he and his colleagues recognize the urgency of this work.
“I’ve been continuously funded by the [National Institute of Health] for 35 years, and I’m very grateful for that,” Chilton said. “There is nothing in my life that has felt this important,” which is why he often works 18 hour days, including on weekends.
After studying the effects of variants on the population, Chilton recognized that building a firewall against COVID-19 through vaccinations may not be enough, especially with the combination of lack of access to the vaccine for some and an unwillingness to take the vaccine from others.
“We may have to go to the other side of the equation,” HE said. “We’ve got to move to specific therapeutics that are agnostic to the variant.”
After seeing enough cases of vaccinated people testing positive amid a surge in the Delta variant that has become the dominant strain of the virus in Suffolk County, local health officials support the federal government’s plan to provide booster doses eight months after the first course of vaccination.
Several studies have pointed to the benefit of boosters, highlighting how people who are vaccinated have lower antibody levels over time and are more susceptible to the highly transmissible Delta variant.
Centers for Disease Control and Prevention Director Rochelle Walensky and Food and Drug Administration Acting Commissioner Janet Woodcock said in a joint statement on Wednesday, Aug. 18, that the government is prepared to offer booster shots for all Americans beginning the week of Sept. 20 and starting eight months after people received their second shots.
A recent study by Mayo Clinic researchers looked at records for 25,0000 vaccinated and unvaccinated patients in Minnesota. The study showed 76% effectiveness in the Pfizer vaccine protecting them from infection, but 42% effectiveness in July during COVID, Sunil Dhuper, chief medical officer at St. Charles Hospital, explained in an email.
At the same time, Health Ministry of Israel data showed a similar progressive decline in the effectiveness of the vaccination in protecting patients from infection over a six-month period, particularly amid Delta variant surges.
Still, the vaccinations continued to provide protection against more serious forms of the disease, with a much smaller 10% decline in the effectiveness of vaccines in protecting people against hospitalizations, Dhuper said.
In physician practices, urgent care centers and emergency departments, doctors are seeing a “sizable number” of breakthrough cases, Dhuper continued.
Adrian Popp, chair of Infection Control at Huntington Hospital/ Northwell Health, said Huntington Hospital has seen breakthrough cases, although most of them are “mild” and are “diagnosed incidentally when patients get admitted for other issues.”
Dhuper urged residents to take precautions similar to the ones they took last year before vaccines were available, including social distancing, wearing masks and washing hands carefully, especially in indoor settings.
At this point, boosters will likely be available for the Pfizer/ BioNTech and Moderna vaccinations. The Food and Drug Administration is still looking at data for people who received the Johnson & Johnson shot.
Once the FDA provides Emergency Use Authorization for a booster for the general population, medical health experts anticipate a much smoother roll out than the initial struggle with finding vaccinations.
“As all who have been vaccinated in New York State have a [Centers for Disease Control and Prevention] vaccine card,” Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, said in an email, “It should be straightforward to each person to get a booster at the eight-month mark.”
At the same time, parents are focused on the timing and availability of vaccines for children under the age of 12. Results from the trial are “expected in December 2020,” wrote Popp.
Medical experts continue to urge residents to receive their shots.
“It is hoped that the booster will cut down on these infections and thus transmissions,” Nachman said.
Many have asked what has happened to us as a society.
As we prepare to remember the victims of 9/11 in just a few weeks, we are reminded of a time 20 years ago when our communities came together to help each other. We applauded our first responders, offered our shoulders to those who were crying and all of us came together as one. The amount of empathy Americans, as well as those around the world, showed for the victims and their families was awe-inspiring. While 9/11 was a day to remember, 9/12 was just as important because it showed that we could be unified.
However, the tragedies and issues caused by COVID-19 have left us more divided than ever. Many scratch their heads wondering why people won’t follow the guidance of medical professionals, who last year simply asked us to wear masks and social distance while they figured out the best line of defense against the virus. Despite the significant strides made in medicine over the last few decades, a new form of a virus can still take time to figure out. And then this year, finally the vaccine that we all were waiting for was released, but yet many have refused to get it to help the common good and themselves.
It seems at times we have become selfish and self-absorbed, not worrying about anyone but ourselves. Then again, we shouldn’t be surprised. Look at our roads. More and more drivers engage in reckless driving, whether speeding down the road, weaving in and out of traffic, not pulling over for emergency vehicles or blowing through red lights and stop signs.
In the days of social media, we see too many people believing that their way is the only way and that those who think differently to them are evil or stupid to a point where we don’t respect our fellow citizens.
We have become so selfish and judgmental at times that we forget when we step out our door it’s no longer about us. The world does not revolve around one person, not even one family or social circle. As we navigate through the day, while our feelings and beliefs are valid and should be respected, the same goes for respecting others. We should also listen to each other. Really listen. It can be difficult at times to balance our wants and needs with the desires of others, but it’s the only way we can live together in peace.
Many have said they don’t want a new normal — they just want normal. Yet, it seems as if a new normal is needed, one where people’s actions show that they care about those around them.
It’s been said that learning about our history is important, so we don’t repeat the mistakes of past generations and benefit from the good elements, too. Now, let’s remember the tragic event of 9/11 and its aftermath in order to be reminded of how we united and moved forward during one of the most difficult times in American history.
Welcome to Dan Dunaief HS or DDHS. I know it’s an odd time to start a new high school, but children need to learn, even during a pandemic.
Originally, I was planning to have everyone come to a pep rally on the first day of school. After all the restrictions of last year, it only seemed fitting to bring the kids together in the gym and celebrate the chance to sit in 1950s style wooden bleachers that rock when someone walks a few steps.
But, then, I realized we don’t have a basketball, football or squash team, we haven’t picked school colors, we don’t have a school song and, most importantly, we are in a difficult spot with the pandemic.
I know your kids are exhausted from dealing with the virus. Who can blame them? Aren’t we all?
At first, I thought we’d avoid the whole topic and stick to the basics in school.
But, then, it occurred to me that avoiding a virus that has now affected three school years wouldn’t make it better. We can try not to think about it, but that doesn’t make it go away. Information and knowledge will help these students understand the strange world that surrounds them and might empower them to feel as if they’re doing something about it, even if it’s just learning more about a time that future generations will no doubt study carefully, scrutinizing our every move as if we were some kind of early laboratory experiment.
With that in mind, I gave the curriculum serious consideration. I thought about all the standard ways students have learned.
Ultimately, I decided to turn toward the academic vortex. At DDHS, at least for the first year or so, we’re going to encourage students to study the real challenges of the world around them.
For starters, in our art class, we’re going to have design competitions for the front and back of masks. The winners will provide masks that the entire school will wear each week.
Then, in an engineering class, we’ll work on creating masks that are more comfortable and just as effective as the ones that make our faces sweat. Maybe this class can also figure out how to provide words that flash across the mask when we talk, giving people a better idea of what we’re saying behind our masks. Maybe enterprising students can design masks that cool our faces when we sweat and warm them when we’re cold, that shave or bleach unwanted hair or that act like dry-fit shirts, covering our faces without clinging to them.
In history, we’ll spend at least a semester on the Spanish Influenza. We’ll explore what leaders throughout the world did in 1918 during the last pandemic. We’ll see what worked best and what disappointed.
Our psychology class will devote itself to the conflicts between people’s perceptions of infringements on their individual freedoms and their desire to protect themselves and each other by wearing masks.
Our political science course will delve into how politics became enmeshed in the response to the virus. This class will look at which side gains, politically, amid different public health scenarios.
Science classes will explore why some people get incredibly sick from the virus, while others show no symptoms. We will also study the way the virus works, look at similar viruses and try to understand and track the development of variants.
Math will work with the science department to understand the spread of the virus and to plot various scenarios based on human behavior. Eager students in math will have the chance to demonstrate how sicknesses spread depending on the wearing of masks, the use of vaccines, and the creation of new variants.
Our language arts class will provide an outlet for students to express their hopes, dreams and concerns amid the unique challenges in their lifetime created by the pandemic.
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