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Dr. Gregson Pigott

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Pixabay photo

By Daniel Dunaief

For many local health care workers, the pandemic transitioned from triggering uneasiness about reports of a respiratory illness coming out of China to a significant threat to area residents.

Dr. Susan Donelan, Photo from Stony Brook Medicine/Jeanne Neville

Health care workers were in an all-out scramble to save lives even as information about the disease, its course and treatment, changed.

Five years after the start of a world-altering pandemic, infectious disease experts and emergency medicine specialists shared a range of thoughts about their initial reactions and concerns about this illness as well as insights about lessons learned and readiness to manage through future significant health threats.

Dr. Susan Donelan, Medical Director of Healthcare Epidemiology at Stony Brook Medicine, remembers raising questions about this virus towards late December of 2019. People urged her to go home and have a nice Christmas.

When Hospital CEO Carol Gomes called her on a Sunday and told Donelan she had an hour to get back to her, she recognized the approaching storm.

“I remember saying, ‘It’s a Sunday and she needs me in an hour,’” Donelan recalled. “We’re in it.”

Indeed, over the following months and, as it turned out, years, doctors dealt with numerous unknowns amid a fluid situation that threatened the population and, in particular those who were immunocompromised, had diabetes or respiratory or cardiac issues.

“People forget how bad things were,” said Dr. Gregson Pigott, Commissioner of the Suffolk County Department of Health Services. “So many people were dying” that hospitals needed to figure out where to put the deceased.

Residents also lined up to get the scarce tests for the presence of the virus and often waited days or longer for a result.

Fluid situation

Health care professionals were reacting to a fluid situation in which best practices in terms of treatment and prevention changed even as the virus was mutating.

“It seems like a blur, going back and thinking about those moments,” said Dr. Jennifer Goebel, emergency room doctor at Huntington Hospital. “It was very surreal, taking care of a disease process you knew nothing about and attempting to be the expert when we were still learning.”

Federal, state and county health officials were unsure of the best guidance for a range of safety measures, including the use of masks.

Additionally, health care experts struggled with the level of contagion based on different environments.

“I don’t think anyone really knew about the continuum that could occur depending on the ambient circumstances,” said Donelan. “I think we probably could have done a better job of letting the public know that our communications would evolve as our knowledge evolved.”

Sharing safety messages

During the worst of the pandemic, health care professionals struggled to share messages that would help people make informed decisions about protecting themselves, their families and their communities.

Dr. Sharon Nachman. Photo frm SBU

“Trust in public health was completely undermined,” said Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital “That hurt all of us.”

Nachman also listened to health care professionals on national TV who were discussing the health crisis. These pundits were sharing information that included far too many inaccessible words and concepts.

“Smart professionals were talking” but people weren’t understanding them, she said.

Additionally, the echo chamber of social media distorted messages, often questioning the developing science and best practices, suggesting conspiracy theories as well as treatments that were either unproven or ineffective.

Having local professionals from area hospitals made a difference on Long Island, Nachman said.

Whenever Nachman went to ShopRite, people who knew she was a part of their community saw her and asked questions.

“When it’s someone local from Northwell, Stony Brook, NYU Winthrop or others, [local communication] really works better,” she said.

Goebel added that she continues to share her medical knowledge not only with patients, but also with family members who have come to the hospital to provide support.

Hospitals, for their part, learned their lesson about stocking personal protective equipment.

“People have learned their lessons” at hospitals, said Pigott. “We need a more adequate stock of PPE.”

Health care provider PTSD

During the worst of the pandemic, one in five doctors who responded to an American Medical Association poll in 2022 said it was likely they would leave their practice within two years.

Dr. Jennifer Goebel. File photo from Northwell Health

“It was so staggering to hear some of these numbers,” said Goebel. Doctors go through over a decade of training. Seeing so many people leave was difficult.

Health care workers struggled, and continue to struggle, with memories and experiences in the midst of a crisis that killed millions around the world.

“I remember going to room nine, intubating a patient and being called to bed 12 and intubating another patient, within a matter of minutes,” said Goebel. 

As the director of wellness in the Emergency Medicine Service Line, Goebel has created new initiatives to help reduce burnout and provide support.

She developed a peer to peer pilot program that started in September in which new physicians, physician’s assistants and nurse practitioners were matched with a more experienced professional from day one.

The effort is designed to help new staff navigate the health system and address any questions or concerns.

“We’re looking to put these processes in place” throughout Northwell, Goebel said. 

Remote medicine

While remote medical choices, such as telehealth, predated the pandemic, these options have become increasingly common, particularly for residents who might struggle to get to a medical visit.

“Because people were forced to use it, with practice, they got better at it,” said Pigott.

Many organizations invested more in telehealth, which also reduces the burden on Emergency Departments.

Teleheatlh has its “risks and benefits,” said Goebel, as it can keep patients who might be vulnerable out of an environment where they might otherwise be exposed to other pathogens.

Goebel appreciates the importance of a visit with a doctor, who can differentiate between an ear ache and a potential indication of shingles.

Fortunately, for many people, Covid has become a much more manageable infection.

Pigott contracted Covid in September. He took Paxlovid, which helped knock out the symptoms within three days.

Pigott is also grateful for vaccines, which provided a dramatic reduction in mortality during the worst of the pandemic, particularly for people who are over 65.

The vaccine was “saving lives,” said Pigott. “There was real evidence that these are doing their jobs and are working out.”

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Image courtesy of Suffolk County Dept. of Health

By Daniel Dunaief

Suffolk County reported its first case of measles in a child since 2017 this week, as an unvaccinated person under five years old contracted the infectious disease.

Suffolk County health officials are working with the New York State Department of Health and Northwell Health and are taking steps to prevent the spread of the disease.

The case of measles in Suffolk County is the third in the state and comes as Texas has had over 200 confirmed reports of measles since January, with 29 hospitalizations, according to the Texas Department of State Health Services.

“Measles can be very serious,” State Health Commissioner Dr. James McDonald said in a statement. “It’s much more than just a rash as complications can include pneumonia and inflammation of the brain, and often results in hospitalization.”

Officials indicated that residents could have been exposed to the person with measles at the pediatric emergency department at Cohen Children’s Medical Center in Queens from March 3rd to March 4th.

Patients who visited an inpatient child on the Medicine 3 unit from March 3rd to March 6th also could have had exposure.

The Cohen Children’s Medical Center, which is run by Northwell Health, is reaching out to patients who were at the center during the time of exposure. The Center has also identified patients who are high risk and may require timely treatment.

“As we follow this case and closely monitor potential exposures, we strongly encourage all residents to protect their health and the health of our youngest and most vulnerable residents by ensuring they are on time and up to date their measles vaccines and all recommended and lifesaving immunizations.” said Dr. Gregson Pigott, Suffolk County Commissioner of Health Services, said in a statement.

The incubation period for measles, which is spread by coughing or sneezing into the air, is 21 days, with symptoms that can include high fever, cough, runny nose and red, watery eyes. The best way to prevent measles, according to health officials, is to get the MMR vaccine. One dose is 93 percent effective at preventing measles, while two doses are about 97 percent effective.

Doctors recommend that residents receive their first dose at 12 to 15 months of age and the second at four to six years of age.

Measles during pregnancy increases the risk of early labor, miscarriage, and low birth weight infants.

Separately, area officials found two dead raccoons tested that positive for rabies in Amityville and North Amityville on March 4th and January 28th, respectively.

These are the first confirmed cases of rabid raccoons in the county since 2009

These animals had no known contact with humans or animals.

“We have over 1.5 million residents [in Suffolk County] and it’s not good to have raccoons running around with rabies,” said Pigott. These animals can get in a fight and can transmit the rabies virus to other animals or to humans.

Left untreated, rabies, which has early symptoms including irritability, headache, fever and itchiness at the site of exposure, can be lethal.

People can contract rabies if they are exposed to saliva or nervous tissue of a rabid animal through a bite.

Pigott urged pet owners to ensure their animals are vaccinated for rabies. He also suggested that people take safety measures when they are out among animals. He asks those living in Huntington, Islip, Smithtown or Babylon to contact the Department of Health Services if they encounter a dead raccoon.

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Flu season is hitting New York and the country as a whole especially hard this year. Stock photo

By Daniel Dunaief

The flu season has hit with a vengeance in February, as a seasonal virus that can be deadly has  become the dominant cause of illness in the area.

Suffolk County hospitals reported 337 residents with influenza in the week ending Feb. 1, according to New York State Department of Health data.

Dr. Sharon Nachman

Just last year, for the 2023-2024 flu season, Suffolk County hospitalizations peaked on Dec. 30 at 52. Even in the year before, when people were starting to wear masks much less frequently than during the peak covid years, flu hospitalizations in the county peaked at 50 on Dec. 17.

“We are definitely seeing more people sick” with flu, said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. The emergency room is “wildly full, and even urgent care walk in is full.”

The number of positive cases of flu A at Stony Brook University Hospital in January was 800. That compares with 400 cases for the same strain last year, according to Nachman.

While the flu is cyclical and can cause different levels of infections from year to year, local doctors suggested that the overall flu vaccination rate was lower this year, which may have increased vulnerability to the virus and extended the time people exhibited symptoms.

The number of people vaccinated is “incredibly lower compared to past years,” said Nachman. On top of that, people may not have been exposed to the flu for several years amid measures to reduce the spread of Covid-19.

Residents’ immune systems may have “no good memory response” if the last exposure to the virus occurred some time before 2020, Dr. Nachman added.

The dominant strain of the flu this year is the A strain, which accounts for about 80 percent of the cases.

Nachman suggested that people who were vaccinated in early September may not have as much resistance to the flu this month, as their peak resistance, which typically lasts about three months, has wained.

Health care professionals added that people who haven’t been vaccinated could still receive the shot, as the flu season could continue to last for a month or more.

Dr. Adrian Popp

“It is not too late to get the flu shot,” Dr. Gregson Pigott, Commissioner of the Suffolk County Department of Health Services, explained in an email.

Dr. Adrian Popp, chair of Infection Control at Huntington Hospital, said the staff has been offering flu shots for residents who have were not already immunized.

“I don’t know how much longer this will last,” said Popp. “It’s still cold and it’ll be cold in March.”

Typically, it takes two weeks for the body to receive full protection from the shot. The shot does provide some incremental benefit immediately.

“You start building immunity from the moment you get” the shot, said Popp.

So far this year, there have been two deaths at Huntington Hospital, which is not unusual for the flu.

Mortality from the flu is “turning into what it used to be,” said Popp, with deaths at about pre pandemic levels.

High risk patients

High risk patients are typically older or have preexisting conditions.

People who have an inability to fight infections can get “much sicker from the flu,” said Dr. Alan Bulbin, St. Francis Hospital and Heart Center Director of Infectious Disease.

Dr. Gregson Pigott

Health care workers urged those who are in higher risk groups either to see their doctors if they start developing symptoms or to use some of the at home tests, including a recent one that can test for flu A and B, as well as Covid.

“If you are immunocompromised, you should have a low threshold,” said Bulbin. “You should speak with a doctor, go to urgent care, and do a swab. That may differentiate influenza” from other infections such as respiratory syncytial virus, or RSV, and Covid.

The antiviral treatment Tamiflu can be effective if people start taking it within 48 hours of developing symptoms. Paxlovid, meanwhile, can also help within a few days of developing covid.

“We urge residents, especially those at risk for severe illness, to contact their medical providers at the onset of symptoms,” Pigott explained in an email.

Lower Covid and RSV levels

While the flu has infected a larger number of people than in previous years, the incidence of RSV and Covid has declined.

In Suffolk County, 90 residents are hospitalized with Covid, while the number of deaths from the virus is 29 since the start of the year, according to the New York State Department of Health.

That compares with 190 residents hospitalized last year and 96 deaths from Covid from Jan. 1 through Feb. 14.

“The virus that causes Covid-19 is still circulating and causing disease, although not as aggressively as in previous years,” Pigott explained.

RSV, meanwhile, rose in the fall, peaked in late December and has been falling since then.

RSV accounted for 0.2 percent of emergency department visits on Feb. 1, Pigott added.

Future ID doctors

Specialists in infectious disease were unsure how the pandemic affected the interest among doctors in training and residents in their field.

For some, the appeal of reacting to fluid circumstances and to gathering insights about a developing disease that could and did affect billions of lives could be appealing. For others, however, the demands, the hours, and increasing politicization of medicine as well as the divided response to vaccines could have pushed them in other directions.

“Am I concerned that not enough people are going into the specialty?” Nachman asked. “Yes.”

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Diet and exercise are the first line of defense for those living with diabetes. Stock photo

Suffolk County Executive Ed Romaine and the Department of Health Services invite residents who are at risk of developing type-2 diabetes to participate in the Suffolk County Diabetes Prevention Program. The program is based off of the National Diabetes Prevention Program that supports moderate behavioral changes and incorporates healthy eating and physical activity.

According to the Centers for Disease Control and Prevention (CDC), nearly 98 million American adults — more than 1 in 3 — are at risk for diabetes.

“We want our residents to be healthy and live fulfilling lives,” said Romaine. “We encourage all adult residents to take a one-minute risk survey to learn if they are at risk for prediabetes. Through educational programming and preventative measures, we are here to help you reduce your risk.”

“Diabetes puts the body at risk for many serious health conditions,” said Dr. Gregson Pigott, Suffolk County Health Commissioner. “The good news is that moderate changes in lifestyle can help restore blood sugar to normal levels and result in significant health benefits.”

The Suffolk County Diabetes Prevention Program has received “full plus” recognition from the CDC, meeting the agency’s highest standards. To date, 440 Suffolk County residents have successfully completed the program.

Residents are encouraged to take the one-minute risk test at www.doihaveprediabetes.org and are invited to attend informational sessions at:

— Smithtown Public Library, 148 Smithtown Blvd, Nesconset on Feb. 24 from 6 p.m. to 7 p.m. 

— Brookhaven Free Library, 273 Beaver Dam Road, Brookhaven on Wednesday, March 12 from noon to 1 p.m. 

— Center Moriches Public Library, 235 Main Street, Center Moriches on March 19 from noon to 1 p.m. 

— Patchogue/Medford Library, 54-60 East Main Street, Patchogue on March 28 from 1 p.m. to 2 p.m. 

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Suffolk County receives “full plus recognition” for fourth consecutive year

The Suffolk County Department of Health Services has received “full plus recognition” from the Centers for Disease Control and Prevention for its Diabetes Prevention Program for the fourth consecutive year. The designation is reserved for programs that have effectively delivered a quality, evidence-based program that meets all the highest standards for CDC recognition.

“Suffolk County residents are incredibly lucky to have available to them a no-cost program that is highly successful at supporting them with modest lifestyle changes to help reduce their risk of acquiring diabetes and other preventable diseases,” said County Executive Ed Romaine.

The Suffolk County Diabetes Prevention Program exceeded the national average in participant risk reduction by roughly 30%. Among program participants last year, 80% achieved a 5% weight loss, 67% participated in 150 minutes per week of physical activity over the course of eight sessions and 27% reduced their baseline HbA1C.

The National Diabetes Prevention Program (DPP) has been proven to prevent or delay type 2 diabetes. The DPP is a year-long program that meets in small groups. A trained lifestyle coach leads the weekly session to help participants improve their food choices, increase physical activity and learn coping skills to maintain weight loss and healthy lifestyle changes.

The initial study, which began in 1997, showed the risk of developing type 2 diabetes was reduced by 58% in adults at high risk for the disease (71% for people over 60 years old). A 10-year follow-up study showed that participants were still one-third less likely to develop type 2 diabetes a decade later than individuals who took a placebo. Those who developed type 2 diabetes delayed the onset of the disease by about four years.

Suffolk County has been a partner in the diabetes program since 2013 and first achieved full recognition for its diabetes prevention program in October of 2016. The standards to achieve full recognition are strict, requiring extensive documentation and demonstration of an average weight loss of 5% across all evaluated participants in the year-long cohort, a 0.2% reduction in HB1c, or a weigh loss of 4% and at least 150 minutes per week of physical activity for 12 months.

To achieve “full plus” recognition, the program must retain certain percentages of a cohort over periods of time. For example, a minimum of 50% of a cohort must be retained at the beginning of the fourth month. Suffolk County’s designation is noted on the national registry website.

“It is not easy to change behavior, but we are making inroads, and we hope to ultimately see improvement in health outcomes as we train more lifestyle coaches in our communities,” said Dr. Gregson Pigott, Commissioner of Health Services. “To accomplish full plus recognition from the CDC is testimony to our dedicated staff who have brought this program to life in Suffolk County.”

To date, 438 Suffolk County residents have participated in the county’s Diabetes Prevention Program.

The Suffolk County Diabetes Prevention Program will be offering a new year-long program at the Suffolk County Department of Health, Office of Health Education in Hauppauge, starting on Monday, March 3, 2025, at 6:00 PM.  Details are posted on the county website. To register, contact Debora Rippel at 631-853-2928 or debora.rippel@suffolkcountyny.gov.

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Photo courtesy Metro Creative Graphics

By Daniel Dunaief

While the fall provides a break from the summer heat and a respite for exhausted parents who coordinate and carpool for recreational activities, it also can trigger a return to more concentrated time indoors.

Dr. Sharon Nachman, Chief of the Division of Pediiatric Infectious Diseases at Stony Brook Children’s Hospital.
File photo

That can trigger the beginning of the flu season, as students and their families share much more than the lessons of the day and stories about teachers and classmates.

Timing shots can be a delicate balance, as the antibody coverage from these shots is typically about three months.

With the peak flu season often occurring during December and January and even into February, Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that residents receive their vaccines in a few weeks.

“Getting a vaccine in October is probably the right time,” Nachman said.

Dr. Gregson Pigott, Commissioner of the Suffolk County Department of Health Services, added that the timing for Covid vaccinations is somewhat trickier.

“Because the evolution of new variants remains unpredictable, SARS-CoV2 [the virus that causes the disease] is not a typical ‘winter’ respiratory virus,” Pigott explained in an email.

The county health department recommends that residents stay up to date with their vaccinations.

“Individuals should speak with their healthcare providers for advice that is specific to them,” Pigott added.

Simultaneous shots

Doctors generally recommend receiving both shots at the same time, if people are eligible and the timing for each vaccine is right. Residents who are unsure about their eligibility should speak with their healthcare providers, Pigott explained.

Dr. Gregson Pigott, Suffolk County Health Services commissioner. File photo

The flu and Covid are viruses that change over time, creating a battle between the pharmaceutical companies that manufacture vaccinations and the viruses that attempt to evade them.

Each year, the vaccines attempt to provide the best match against the dominant or most likely strains.

The Centers for Disease Control and Prevention “determines if the vaccine will protect against a circulating virus by conducting laboratory studies on circulating flu viruses,” Pigott explained in an email. “Updated 2024-2025 flu vaccines will be trivalent” and will protect against H1N1, H3N2 and a B/ Victoria lineage virus.

Vaccine manufacturers create immunizations based on the flu strain circulating in the southern hemisphere during the recent season.

“We expect that those are what’s going to hit us in our winter,” Nachman said. “The science is there. We know generally what types will be rolling around. We could hit or miss it by a subtype.”

Nachman added that the flu vaccines represent educated guesses about the type of microbe that might cause illnesses.

“The educated guesses are still better than no vaccine, which will, for sure, not cover you at all,” Nachman said

As for the Covid immunization, doctors added that it is also likely to change as the virus that caused the pandemic mutates.

Nachman said people should plan to get the Covid shot around once a year.

“I don’t think we’re going to go to more often” than that, Nachman said.

During the summer, when an infectious strain of Covid surged across the county, state and country, Nachman said the data is not available to determine how much protection a vaccine provided.

“Only on TV do computer models work instantly,” Nachman said.

She suspects that the Covid shot offered some protection for residents, who may not have been as sick for as long as some of those who dealt with a range of symptoms.

Concussion awareness

With the start of a new school year and the beginning of contact sports like football, school districts are continuing to ensure that coaches and athletes follow concussion protocols.

“Schools have done a nice job thinking and talking about it,” said Nachman. “Coaches know you can’t throw [student athletes] out and say, ‘You’ll do fine,’” after a head injury.

Nachman suggested that area athletes may engage in activities that are not connected to the schools and that may involve head injuries that people ignore.

“We know what’s happening with school-regulated” sport, but not with those that are outside the academic umbrella, she added.

As for the emotional or psychological impacts of a divided and bitter electorate during an election year, Nachman said people are under considerable emotional stress.

“The social media echo chamber is making it worse,” she said. The abundance of misinformation on both sides is causing mental anguish.

“Election times are very stressful and I think, in particular, this election may be even more stressful,” Nachman said.

Nachman urges people to minimize their time on social media and to create down time from electronics during meals.

As students move up a grade and into new places, they also can endure stressors, peer pressure and bullying. She suggests that parents understand what their children are seeing online.

Newborn RSV protection

Children born in March or later are eligible to receive an approved shot called Beyfortus, which, in 80 percent of cases during clinical trials, prevents the development of respiratory syncytial virus, or RSV.

The Beyfortus monoclonal antibody will make a “huge difference” for newborns and their parents, Nachman said. Last year, Stony Brook had numerous hospitalizations in children under one year of age.

“We’re not going to have those children coming into the hospital,” Nachman said. “That’s amazing and is a huge step forward.”

When newborns get RSV, doctors don’t have an effective treatment for the virus and typically treat the symptoms.

The mortality rate from RSV is low, but the morbidity is high. Newborns who contract RSV can end up developing chronic asthma.

As with any shot, Beyfortus can have side effects, with the most common including rash and pain, swelling, or hardness at the site of the injection, according to AstraZeneca and Sanofi, which manufacture the antibody.

Beyfortus is covered by insurance and is under the vaccine for children program and numerous private health insurance plans. Parents can opt out of the shot. Nachman suggested they should understand what they are opting out of when they make that decision.

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An aedes albopictus mosquito, better known as the Asian tiger mosquito. Pixabay photo

By Daniel Dunaief

Mosquitoes can be much more than a nuisance as they search for their next blood meal: they can also pass along potentially dangerous viruses.

Long considered a tropical and subtropical health threat, dengue fever has reached record levels in the Americas this year. The illness has been traveling with Aedes mosquitoes that have been moving further north amid global climate change.

As of early July, mosquitoes in Texas, Florida and California have had one of the four viruses associated with the disease. Through early July, Florida reported 10 cases from local spread, according to an American Medical Association update.

Suffolk County residents who have traveled into areas that have dengue have contracted the illness, which has symptoms that are similar to the flu, such as high fever, headaches, body aches, nausea, vomiting and a rash.

Suffolk County has reported 12 cases of travel-related dengue so far through early July, which is more than all of last year and is the highest level since 2013, when 13 cases were reported for the entire year.

“We do have a fair amount of concern with global warming,” said Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “Even if people do not believe in it, mosquitoes have changed where they’re located. There is concern that the mosquitoes” will continue their trek farther north.

Suffolk County is one of many places throughout the country and the Americas that have reported an increase in cases for a disease for which residents have generally had no exposure and, as a result, no natural immunity.

New York State Department of Health alerted medial professionals to consider dengue as a diagnosis if people who are sick have a travel history and related symptoms, Dr. Gregson Pigott, Suffolk County Health Commissioner, explained in an email.

Symptoms of dengue typically begin within two weeks of being bitten by an infected mosquito.

From January 1 through June 24, countries in the Americas reported more than 9.7 million dengue cases, twice as many as in all of 2023, according to the Centers for Disease Control and Prevention.

Indeed, in Puerto Rico, infection levels climbed so high in early April that the Puerto Rico Health Department declared a public health emergency.

While a majority of dengue infections are asymptomatic or produce mild illnesses, the virus can cause severe cases and can be fatal, according to the World Health Organization.

“Anyone who lives in or travels to an area with risk of dengue is at risk for infection,” Pigott explained. “Children and those who are elderly are at higher risk for serious illness.”

People with dengue typically receive supportive care, which includes rest, pain medications and fluids.

Protection

Health professionals urged people traveling to areas with dengue to take a number of steps to protect themselves.

EPA-registered insect repellents, coupled with loose-fitting, long-sleeved shirts and pants can keep mosquitoes away.

Additionally, people can treat their clothing and gear, including hats, shoes and socks, with permethrin.

“Don’t be around standing water, which is a wonderful place for mosquitoes to breed,” advised Nachman.

In Suffolk County, the arthropod-borne disease lab collects mosquitoes and sends them to the New York State Department of Health lab in Wadsworth, New York. Asian tiger mosquitoes, which have carried dengue, zika and chikungunya viruses, have been found in Suffolk County, Pigott added.

“No samples of Aedes albopictus mosquitoes that have been sent to the lab have tested positive for those viruses,” Pigott wrote.

While health professionals are on the lookout for potential cases of dengue among residents who have traveled, they are more concerned currently with West Nile virus, which people can contract locally.

Other local illnesses

As for illnesses in the county, Nachman has seen patients who have been battling a collection of viruses, including enteroviruses and Covid.

Residents who are staying around Long Island should continue to be careful about ticks that can carry Lyme disease. Anyone who is going hiking should consider long pants and long sleeves, as well as dirt on their clothing.

“If you take your kids out to hike, check them and you for ticks,” said Nachman.

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Firefighting foam erupts from fire hose a product that is a regular host of PFAS chemicals, resistant to oil and water. Pixabay photo

By Daniel Dunaief

Forever is wonderful when it comes to love, but not so much when it comes to chemicals that don’t break down and stay in the human body, accumulating over time and threatening people’s health.

In a move applauded by environmental advocates and health officials, the Environmental Protection Agency last week set a limit on the amount of so-called forever chemicals, such as per- and polyfluoroalkyl substances, called PFAS, of four parts per trillion in drinking water.

Water companies have until 2027 to complete initial monitoring to reduce chemicals that have been linked to damage to the kidney, testes, liver, thyroid, reproductive and immune system, according to the new regulations. Found in a host of products including fireman’s foam, carpets, clothing, food packaging and nonstick cookware, PFAS are resistant to oil and water.

New York State already had one of the toughest regulations in the country, as the Empire State set maximum contaminant levels of 10 parts per trillion for these chemicals in 2020.

Charles Lefkowitz, chairman of the Suffolk County Water Authority applauded the EPA for this new national standard.

The SCWA has been “preparing for this and we are well on our way to meeting all regulatory requirements within the time frame laid out by EPA,” Lefkowitz said in a statement. “Since 2020, when New York enacted its own PFAS rules, SCWA has been meeting or surpassing all standards. It has given us a great head start on the new rules, but there is still work to be done.”

Suffolk County Health Commissioner Dr. Gregson Pigott noted that the state’s water standards for emerging contaminants are among the most protective in the country.

“The new federal measures will have the greatest impact nationwide and will also further protect our drinking water on Long Island,” Dr. Pigott explained in an email.

Environmental groups recognized the ongoing work at the SCWA to meet these standards and appreciated the authority’s public disclosure of its testing results.

Adrienne Esposito, Executive Director of Citizens Campaign for the Environment, described the SCWA as “ready” for this rule change and “poised for action.”

Since 2016, the SCWA installed 27 new Granular Activated Carbon treatment systems that remove PFAS from drinking water, The authority expects to install as many as 80 new GAC systems to meet the new regulations.

“We are well within our way to achieving that within the timeframe set by the EPA,” Jeff Szabo, Chief Executive Officer of SCWA, explained in an email. 

Each new system costs about $1.5 million to install. SCWA had already instituted a $20 per quarter water quality treatment charge to customers in 2020, when New York State established its PFAS limits.

SCWA has also secured $9 million from New York State for GAC treatment, which, Szabo explained, would help reduce the cost to customers.

Rates won’t be increasing in the next fiscal year. The rates, which are based on the budget, may change in future years, depending on the operating budget, a spokesman said.

SCWA tests all of its wells at least semi-annually for PFAS. If the authority finds a well with these chemicals, it retests the well at least quarterly and, in some cases will test it every month or every two weeks.

Private  wells

Esposito urged people with private wells to test their water regularly.

“People think when they have a private well, it comes from a mysteriously clean spring,” said Esposito. “They must get their wells tested. Ignorance is not bliss. If there are PFAS, they must call and report it and see if they’re eligible to get federal funds for filtration.”

Esposito estimates the cost of testing for private well water could be $200 to $250.

Carbon filtration, using a process called reverse osmosis, can remove PFAS.

The cost of installing filters depends on the home and the type of filter. Several online providers estimate a cost between $800 and $3,000, although specific costs from different providers may vary.

Residents can call the Department of Health Services Office of Water Resources at (631) 852-5810 for information on testing by either the health department or a local contract laboratory. Health department staff are also available to provide treatment recommendations.

The New York State Department of Environmental Conservation has provided alternate water supplies to a limited number of private well owners on a case-by-case basis over the last several years.

The New York State legislature is considering proposed legislation to provide grant funding to private well owners with impacted wells to connect to public water or install treatment.

The county health department coordinates with the DEC and the state Department of Health when they receive information regarding water that exceeds PFAS containment levels.

People interested in further information about the health effects of the PFAS are urged to reach out to the New York State Department of Health.

Jaymie Meliker, Professor in the Department of Family, Population and Preventive Medicine in the Program in Public Health at Stony Brook University, added that private wells have numerous potential contaminants in part because Long Island has so many septic systems.

These wastewater systems are a source of nitrogen for waterways, leading to fish kills and can also add contaminants to drinking water.

Wastewater treatment is “vastly under resourced,” said Meliker. The county and the state need infrastructure investments.

As for PFAS, they can vary from one neighborhood to the next.

On the manufacturing side, companies are working to lower the toxins of PFAS, creating shorter chains that provide the same benefits without the negative effect on health.

Meliker was pleased that the EPA had established low level limits for these chemicals that accumulate in the human body.

The studies and concerns have been “going on for a couple of decades,” he said. “There’s enough evidence to suggest it’s prudent to do something.

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By Daniel Dunaief

Decades ago, doctors endorsed cigarette smoking, promoting it in advertisements. That was back in the 1950’s, in the decade after the U.S. government shipped cigarettes to members of the armed forces during World War II.

On Jan. 11, 1964, Surgeon General Luther Terry released a landmark report that showed a nine to 10-fold higher risk of lung cancer for smokers compared with non smokers. At the time, about 40% of the adult population smoked. The report helped dramatically alter the perception of smoking. Indeed, a Gallup Survey from 1958 showed that 44% of Americans believed smoking caused cancer. By 1968, that number surged to 78%, according to a report from the National Institutes of Health.

Pulmonologist Dr. Norman Edelman, a professor of medicine at Stony Brook University and a core member of the program in public health at Stony Brook, celebrated the legacy of that landmark report, even as he urged ongoing efforts to reduce smoking.

Dr. Norman Edelman. Photo courtesy Stony Brook University

“It was a momentous occasion,” said Dr. Edelman, who suggested that the number of deaths in the country would be even higher without this report. 

“By the beginning of the 1960’s, the medical literature was pretty clear that smoking causes lung cancer” but the tobacco lobby fought against warnings about the hazards of smoking, Edelman said.

Dr. Gregson Pigott, Suffolk County Health Commissioner, described the report as the “first step towards protecting the American people from the deleterious effects of tobacco use.”

Adult smoking rates have fallen from about 43% in 1965 to about 11.5% in 2011, according to Dr. Pigott.

The report, which was followed by 34 studies from the CDCs Office of Smoking and Health on the health consequences of smoking, validated the concerns of organizations like the American Cancer Society and helped reduce the prevalence of a habit that can have significant and fatal consequences.

“Smoking levels in teenagers are going down,” said Dr. Edelman. “It’s beginning to show up in the health effects” with lung cancer declining in men and plateauing in women.

Lung cancer deaths in men have fallen to 25.5 per 100,000 in 2021 from 65 per 100,000 in 1990, according to Dr. Pigott. More recently, smoking exacerbated the threat from Covid. An analysis of 22,900 people published in BMC Public Health in 2021 showed that 33.5% of people with a history of smoking experienced disease progression, compared with 21.9% of non-smokers. 

A ways to go

While smoking is not as prevalent as it had been in the 1960’s, it is still a killer, accounting for an estimated 480,000 deaths each year in the United States, according to the Centers for Disease Control and Prevention. That’s about one in five deaths each year.

“Smoking still kills more people than other preventable causes of death,” said Dr. Edelman.

Dr. Edelman recognized the severity of other problems like the opioid and overdose crisis. In 2023, the CDC estimates that over 112,000 people died from overdoses.

Still, even with a reduction in smoking, the number of people who are smoking is high enough that the public should continue to look for ways to cut back on the harmful habit.

Over 16 million people live with at least one disease caused by smoking and 58 million non smoking Americans are exposed to secondhand smoke, explained Dr. Pigott, citing CDC data. Second hand smoke causes 40,000 to 60,000 deaths per year in the country, while smoking-related illnesses, which combine direct medical expenses, lost productivity and second hand smoke exposure, cost over $300 billion per year. 

Increasing the cost of cigarettes has helped serve as a deterrent, Dr. Edelman said.

Suffolk County operates a smoking cessation program, which provides behavior modification and supportive pharmaceuticals to medically eligible participants, Dr. Pigott explained in an email. A nurse practitioner oversees the cessation groups, which the county provides at no cost to participants, who also receive personalized follow-up.Stony Brook has several cessation resources. Students interested in smoking cessation can consult a student health care provider who will help them develop a program.

Prescription medications, which are covered under student’s health insurance, are available at a pharmacy after a consultation with a student’s health care provider. 

As for vaping, Dr. Pigott described it as “highly addictive” and explained that its long-term effect is not yet fully understood.

The 2023 Annual National Youth Tobacco Survey found that more than 2.1 million youth currently use e-cigarettes, which represents 7.7% of students in high school and middle school. 

“We are especially concerned about the effect of vaping on young people,” Dr. Pigott added. 

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Suffolk County Executive Steve Bellone has announced that the County will host a free test kit and KN95 mask distribution event on January 24 between noon and 6 p.m. in the lobby of the H. Lee Dennison Building, located at 100 Veterans Memorial Highway in Hauppauge.  Approximately 1,000 test kits and nearly 1,000 KN95 mask will be available for residents to pick up.

All Suffolk County residents are encouraged to attend to obtain kits for their household. Each resident is eligible to pick up two test kits per household member. Test kits will be distributed on a first-come, first-served basis.

“While many of us have resumed daily life, living with COVID-19, it is still important that everyone has access to the tools available to prevent exposure and spread,” said Suffolk County Executive Steve Bellone. “As we continue to see new variants, it is clear that availability to test kits is imperative as we work to keep this virus under control.”

“Testing is still crucial to slowing the transmission of the SARS-CoV-2 virus. When we test positive early in the course of illness, we have the opportunity to seek treatment to prevent the worst outcomes from COVID infection, and can limit the spread of the virus to others,” added Dr. Gregson Pigott, Suffolk County Health Commissioner.

Together, with local municipalities, County legislators, the Suffolk County Police Department, community groups, not-for-profits and more, the County has distributed approximately 660,680 test kits to residents, including seniors, first responders and other vulnerable populations.

Suffolk Health is also offering COVID-19 vaccines and boosters to all Suffolk County residents who are eligible to receive them. Childhood vaccinations are also offered for children who are uninsured. Walk-ins are welcome.

County clinic dates and times are available as follows:

January 24 from 11 a.m. to 3 p.m. at Sachem Library, 150 Holbrook Road, Holbrook

January 25 from 11 a.m. to 3 p.m. at Riverhead Library, 330 Court St., Riverhead

January 31 from 12:30 p.m. to 3:30 p.m. at West Babylon Library, 211 Route 109, West Babylon

For more information, call 631-853-4000.

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