The spread of the new coronavirus has become increasingly likely in the United States, public health officials suggested, as the sickness that started in China has infected people in 39 countries including Italy and South Korea where an American service member has contracted the virus.
During a conference call with reporters on Tuesday, Nancy Messonnier, the director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, said it was “not a question of if this will happen but when this will happen and how many people in this country will have severe illnesses.”
Messonnier’s warning included a suggestion that people start asking their schools about plans for dismissal and for conducting classes online if the coronavirus, now called Covid-19, affects their communities.
Stocks fell sharply lower on Monday and Tuesday amid concerns about the effect on the global economy.
As of earlier this week, over 80,000 people had tested positive for Covid-19, which claimed the lives of over 2,700 people. In the United States, the number of confirmed cases, including those from the Diamond Princess cruise ship, had reached 57. None of those cases is in New York, where 26 tests have come back negative and one is still pending, according to the New York State Department of Health.
Bettina Fries, the chief of the Division of Infectious Diseases in the Department of Medicine at the Renaissance School of Medicine at Stony Brook University, said the infections in Italy and South Korea signaled a new phase in the epidemic.
“We are now having these new cases where we can’t even link them” to exposure to people who have traveled to China, Fries said. “The genie is out of the bottle. Once that happens, it’ll be that much harder” to contain the virus.
Fries described the virus, which health officials believe is transmitted through droplets from people carrying the infection, as “behaving much more like the flu,” which is why the CDC is preparing for cases in the United States.
With other coronaviruses, including severe acute respiratory syndrome and Middle East respiratory syndrome, the majority of patients who transmitted these diseases had symptoms like high fevers. That may not be the case with Covid-19, as patients that are “asymptomatic could be shedding the virus,” making it more difficult to contain, Fries said.
Medical professionals don’t have any medication or vaccine, while the world population, which hasn’t been exposed to this new virus, also hasn’t developed any kind of resistance.
If pockets of the outbreak appear in the United States, it is “conceivable that schools could shut down and that there could be rules where people self quarantine” for the required 14 days, Fries said.
Fries added that it’s important to protect health care providers who are on the front lines in this battle. Stony Brook is continuing to make contingency plans in the event of confirmed cases of this coronavirus, which includes making space available if necessary. In the event of an outbreak, the hospital would change its policy of having trainees, residents and medical students go in and out of rooms with doctors on rounds, she said.
Fries added that the warmer weather may not cause a reduction in the incidence of the virus. “Every virus is different,” Fries said.
On Wednesday afternoon, Gov. Andrew Cuomo (D) announced several measures to prepare New York for the potential spread of the new coronavirus, called Covid-19, to the Empire State. Cuomo announced a $40 million appropriation for the New York State Department of Health to hire additional staff, procure equipment and any other resources necessary to respond to the spread of Covid-19. The governor is also proposing legislation to grant authority to the Department of Health Commissioner Howard Zucker to make sure local health departments and private and public hospitals take necessary actions in response to the virus. The department will bring together local health departments and hospitals statewide to review protocols, practices and procedures to make sure they are prepared to combat the spread of Covid-19.
Cuomo is also asking the federal government to authorize the Wadsworth Center and NYC Public Health Laboratory to test for the virus, which would speed up the test results. New York State has developed and validated a test using the protocol of the Centers for Disease Control. Once Wadsworth receives Food and Drug Administration approval, it can test people under investigation in New York and other northeastern states.
The Department of Health will coordinate with the Mass Transit Authority, Port Authority and airport operators and the workforces for these public transit systems to ensure workers are trained and can access supplies such as cleaning and protective equipment, that they need to operate mass transit and airports. New York is working with all state agencies to prepare for the potential pandemic.
Updated Feb. 28 to include information about Cuomo’s measures.
Mather is one of four separate Northwell hospitals approved for a catheterization lab. The hospitals are looking to compete for services amongst some of the larger health entities in New York state. Photo from Northwell
Mather Hospital in Port Jefferson will soon be joining nearby Stony Brook as one of the few places on Long Island to contain a cardiac catheterization lab to provide less invasive heart-related services.
New York State approved Northwell Health, which includes Mather in its group, to open four cardiac labs at different locations in New York. Alongside Mather, Lenox Health Greenwich Village, Plainview Hospital and Northern Westchester Hospital in Mount Kisco have been approved for labs. The lattermost was approved in December.
According to a Northwell release, these labs specialize in using X-ray guided catheters help open blockages in coronary arteries or repair the heart in minimally invasive procedures — ranging from stenting to angioplasty and bypass surgery – that are less traumatic to the body and speed recovery.
The approval means a big leap for the Port Jefferson hospital, which plans a $11.4 million, 3,644-square-foot addition that will include catheterization and electrophysiology labs. The construction is expected to finish and both labs be open by early 2021.
“With the investment in these four new PCI programs, we are able to advance our mission of improving access, as well as bringing high quality complex cardiovascular services to our patients in their local communities,” William O’Connell, executive director of cardiology services at Northwell Health, said in a release.
Mather president, Kenneth Roberts, has said in a previous interview with the Port Times Record that a big reason the hospital signed on with the health care network is to have the ability and room to innovate at the hospital and keep up with the times. He echoed that sentiment in a statement.
“With Northwell’s guidance and the diligence of our Mather team, Mather received approval from the New York State Department of Health to provide advanced cardiology programs which include cardiac catheterization, PCI and electrophysiology services,” he said. “Approximately 150 patients every year are [currently] transferred from Mather or St. Charles to have these services elsewhere.”
The 2020 U.S. Census could be pivotal for New York, which could potentially lose one or two U.S. reps from a general loss of population. Stock photo
It’s a once-in-a-decade request, and this year’s census could determine just how much local schools, governments and nonprofits get in aid from the federal government. Not to mention, this year’s count could determine if New York could be sending one or two less U.S. representatives to Washington out of its current total of 27.
It has enough officials worried that New York State is funneling money around to different counties to get people to fill in the survey. Suffolk County is expected to receive $1.019 million toward its efforts. Officials have called for additional funds toward the census in this year’s budget, though most don’t expect the money to materialize before the census starts rolling in mid-March. New York State has made $20 million available of a total of $60 million to go toward engagement efforts in local municipalities. $15 million is going to the state’s 62 counties.
“It’s the principle that we count, and we should be counted.”
— Martha Maffei
This year, galvanizing the populace to take the census has become a phenomenon, with players at the state, county and local level putting a heavy emphasis on this year’s survey. On the line, advocates say, is a correct political representation on a federal level as well as $675 billion annually in federal funds for prioritizing road work, school aid, grants and Medicaid funding.
Due to the 2010 census, New York lost two congressional seats, and some have said this year’s count could lose the state one or two more. Local groups, both small and large, have the task of energizing enough people to gain an accurate headcount.
Like herding cats, that’s much easier said than done
Suffolk County Complete Count Committee was created in 2019 in part by the nonprofits Health & Welfare Council of Long Island and Long Island Community Foundation to generate engagement for those efforts.
Rebecca Sanin, president of HWCLI, said they have around 300 groups, including nonprofits, religious organizations, business organizations and governments, participating at least to some degree in outreach among 11 subcommittees. The nonprofit has also established guidebooks and graphics for everyone from immigrant leaders to hospitals to senior citizens.
“We’re really trying to build momentum, where the end is a 10-year funding impact to our region,” Sanin said.
The committee has become a hub for joining up the disparate groups looking to promote the census. The state has its own CCC, and other counties have been encouraged to create their own committees. County Executive Steve Bellone (D) was named to the New York State Complete Count Committee by Gov. Andrew Cuomo (D).
“Suffolk County is not only the largest suburban county in the state of New York, but we have the fourth largest and hardest-to-count populations in New York state,” Bellone said during a 2019 meeting with the Suffolk Complete Count Committee. Approximately 40 percent of county residents live in hard-to-count areas, he said.
People will start to see this year’s census mailed out in mid-March, and the census process continues for the next several months. Stock photo
County officials have hosted census job fairs this year and last, with positions paying $17 to $23 an hour.
Governments at both county and town level have started putting notices of the census in official emails and releases. Brookhaven Councilwoman Valerie Cartright (D-Port Jefferson Station) had been drafted to partner with the complete count committee. She said the town is working on a project with the tax receiver’s office to send out a reminder in the midyear tax receipts that goes out to every household in Brookhaven. They have also started to include information about the census in town programs hosted this year and had representatives from the census table at town events.
“Undercounting of communities can have a domino or ripple effect on community projects and issues for years to come,” the councilwoman said in an email. “A complete and accurate count of your community can result in improved infrastructure and schools, better community health and programs and much more.”
Steven Collins, who works for the U.S. Department of Commerce as a partnership specialist for the census in Suffolk, said the big game changer this year is the now-four different ways residents are going to be able to respond to the census. People can now respond over the internet, over the phone or using the usual mailed in paper survey. The fourth way is when all other options are exhausted, and when census operators have tried to reach an individual by several other means, an enumerator will knock on one’s door.
Though not all see the incentivized online component as a good thing. Sanin said there are many who have a general distrust of putting information online, due to the many examples of private companies being hacked to get access to a user’s personal data. There is also a large digital divide, and many still do not have easy access or understanding how to use the online component.
Despite the online component, census promotion still requires boots on
the ground
Stony Brook University has been active in trying to get students signed up for the count but have also started concerted efforts to encourage indigenous groups, especially those living on Long Island’s South Fork, to sign on for the census.
Despite how seriously census takers have been in requesting surveys, that still has not stopped multiple areas coming back with low response rates, some barely above 50 percent.
In Suffolk County presentations to the complete count committee, some communities are shown as much harder to count than others. While much of the North Shore shows a response rate of 70 percent or better, a large area in Huntington and Huntington Station, with sizable minority populations, have a response rate of 60 percent, at worst.
At www.censushardtocountmaps2020.usa, researchers have used previous census data to track which areas showed lower census participation.
In Brookhaven, one area with low turnout happens to be around the hamlets of Ridge and Upton and in Selden and Centereach, especially in the area along Route 112 that has a previous response rate of only 60 to 65 percent.
There are portions of Long Island with much worse representation. There are certain parts of West Babylon with a response rate as low as 0 to 60 percent.
SEPA Mujer, a nonprofit immigrants rights advocacy group, has chapters in several of the areas that show low response rates, including Riverhead, Huntington Station and Patchogue. Martha Maffei, the executive director of the nonprofit, said they have formed coalitions at two of their three chapters specifically to energize the community for the census. Many of their organizers and members have advocated for local immigrants to take the census which comes with the task of convincing the immigrant community the information will not be used against them by immigration enforcement.
“It’s the principle that we count, and we should be counted,” Maffei said.
Usually, she said, organizers take the tack of arguing that filling out the census will mean more funding for their school districts and how it will offer them better political representation.
The complete count committee has organized 13 total groups on the immigration subcommittee who have all pledged to move through these communities. The issue, she said, is money, compounded with the amount of ground these volunteers have to cover, with only the some $1 million to be spread amongst all of Suffolk.
“Fear nurtures an undercount, and an undercount nurtures our continued inequity.”
— Rebecca Sanin
Still, she’s optimistic these hard-to-count areas will be more active than 2010.
The census is meant to track everyone, including those undocumented immigrants, in order to get a full understanding of total population, but in 2019 the potential for a citizenship question to appear on the census created a tornado of partisan bickering, with opponents saying such a citizenship question would specifically target Latino groups and incentivize them to not respond to the census, thereby limiting the political capital such groups could wield. Officials said the pro-citizenship question was needed to enforce the Voting Rights Act of 1965, designed to help blacks overcome legal barriers to voting during the Jim Crow era.
In November of last year, The New York Times reported on disclosures from the White House hinting that Republican strategists had political reasons for encouraging a citizenship question, that it would increase Republican influence and political power once totals for the census were drawn by undercounting residents in largely Democratic areas.
Judges ruled the question illegal under Title 13, which states the government can only use data from the census for statistical purposes. Collins reiterated there will be no citizenship question on this year’s census, and all information is kept extremely confidential and secure.
Yet the idea still lingers in the minds of some residents, and it is something census advocates said they have had to work around.
Sanin and Maffei said the citizenship question has undoubtedly had a cooling effect toward the census, though to what extent is hard to gauge.
“We feel we are going from one attack to another,” Maffei said. “There is a lot of trauma in this community.”
The general distrust in government and in government systems is high, and trying to encourage people “living in the shadows,” as Sanin put it, is where much of the past year’s efforts have gone.
“Fear nurtures an undercount, and an undercount nurtures our continued inequity,” she said.
4-year-old Gianna C. with BODYTRAFFIC dancers Haley Heckethorn
4-year-old Gianna C. with BODYTRAFFIC dancers Haley Heckethorn
Haley Heckethorn and Tiare Keeno dance for Gianna and her mom
BODYTRAFFIC dancers, from left, Haley Heckethorn, Jamal White, Guzmán Rosado, Tiare Keeno, Rachel Secrest and Ethan Colangelo
The dancers have fun in the lighthouse in the children's hospital's waiting room
By McKenzi Murphy
Sitting cross-legged on the floor of a vibrantly lit playroom, a little boy gleefully fiddled with a box of Mr. Potato Head toys. Flanking him on both sides, delighted at his antics, members from the Los Angeles-based contemporary dance company BODYTRAFFIC, Haley Heckethorn and Tiare Keeno, joined the little boy in his creations.
On the morning of their performance at Staller Center for the Arts on Feb. 8, Heckethorn and Keeno, along with the rest of the company, headed over to the new Stony Brook Children’s Hospital to spend time with a few of its patients. It was there, within newly painted and decorated walls lined with oceanic-themed paintings and paper mache art, that they met with and performed for about a dozen of the 40 patients.
“It’s always very rewarding to be able to give back to the community and spread the joy of dance with everyone, but especially with those who are really in need of a pick-me-up,” Jamal White, a dancer and BODYTRAFFIC’s social media manager, said. The last little girl he visited became his favorite because of her delightful laughter. While two of his colleagues went through some of their steps, she sat giggling and clapping along. “It was the cherry on top,” he said.
While the younger children seemed more interested in playing with the dancers and showing off their toys, some of the older children had an opportunity to ask the dancers questions about their work and the company, familiar territory for many of the performers. Throughout their tours, BODYTRAFFIC often goes on outreach missions. Usually, they visit schools and teach students a few of their modern moves, or go into retirement homes and work with elderly residents. However, for some of them, going into a children’s hospital proved to be a new experience.
“It’s one of my favorite experiences so far,” Heckethorn, who has been with the company for two and a half seasons, said. “It was really lovely and especially doing that on a show day, it really inspires and brings a lot of energy. We travel so often and it is really taxing, so [events] like going to a children’s hospital reminds us of why we dance and why we love it so much.”
Splitting off into smaller groups, the dancers were able to visit a few patients in their rooms where they showed off a modified version of a dance they would later perform in front of hundreds at the sold-out show at the Staller Center. A few children even joined them in learning some steps after some encouragement.
“We visited this one five-year-old,” Rachel Secrest, a dancer new to BODYTRAFFIC’s season, said. “His name was Chris and he recently had surgery and was connected to a machine which was helping him. At first, we came in and he just laughed at us as we danced. We showed him some moves, and he was giggling and nervous, but his mom was with him and got him up and out of the bed. He still has it inside of him to want to dance.”
An emotional but so very rewarding experience, getting to spend time with the children became a bright spot in an otherwise high-stress day.
“It’s tough seeing these kids who are quite sick and hooked up to different machines,” Secrest continued. “But as much as I could I was trying to really look at their faces and do what I could to make them forget their troubles for a minute. I was seeing a kid I wanted to connect with and share a dance with.”
General operating support was made possible by the New England Foundation for the Arts’ National Dance Project with funding from the Doris Duke Charitable Foundation. The Outreach program was coordinated by the Staller Center for the Arts, Stony Brook Children’s Hospital and BODYTRAFFIC.
Paul Newland, Outreach director at the Staller Center for the Arts said, “It was a wonderful collaboration, and we look forward to working with the Children’s Hospital again soon.”
Peng Zhang, center, with four of his students from his power systems class, from left, Marissa Simonelli, Ethan Freund, Kelly Higinbotham and Zachary Sola, who were selected as IEEE Power and Engergy Scholars in 2017. Photo by Mary McCarthy
By Daniel Dunaief
If Peng Zhang succeeds in his work, customers on Long Island and elsewhere will no longer lose power for days or even hours after violent storms.
One of the newest additions to the Department of Electrical and Computer Engineering at Stony Brook University, Zhang, who is the SUNY Empire Innovation associate professor, is enhancing the resiliency and reliability of microgrids that may be adaptable enough to provide energy to heat and light a home despite natural or man-made disruptions. Unlike the typical distributed energy network of most utilities around the country, microgrids are localized and can function on their own.
Peng Zhang. Photo from SBU
A microgrid is a “central theme of our research,” said Zhang, who joined Stony Brook at the beginning of September. “Even when a utility grid is down because of a hurricane or an attack, a microgrid is still able to supply the local customers” with power. He is also using quantum information science and quantum engineering to empower a resilient power grid.
Zhang expects that the microgrid and utility grid will be more resilient, stable and reliable than the current system. A microgrid will provide reliable power even when a main grid is offline. The microgrid wouldn’t replace the function of the grid in the near future, but would enhance the electricity resilience for customers when the central utility is unavailable or unstable.
Part of his motivation in working in this field comes from his own experience with a weather-related loss of power.
Even though Zhang, who used his training in mathematics to develop an expertise in power systems, had been working on wind farms and their grid integration, he decided after Hurricane Irene and a nor’easter that he should do more research on how to restore power after a utility became unavailable.
Irene hit in August, while the nor’easter knocked out power in the winter. After the storms, Northeast Utilities, which is currently called Eversource Energy, asked him to lead a project to recommend solutions to weather-induced outages.
Zhang plans to publish a book through Cambridge University Press this year called “Networked Microgrids,” which not only includes his previous results but also presents his vision for the future, including microgrids that are self-healing, self-protected, self-reconfiguring and autonomous.
He recognizes that microgrids, which are becoming increasingly popular in the energy community, present a number of challenges for customers. For starters, the cost, at this point, for consumers can be prohibitively high.
Zhang can cut those expenses, however, by replacing hardware upgrades with software, enabling more of the current system to function with greater resilience without requiring as many costly hardware modifications.
His National Science Foundation project on programmable microgrids will last until next year. He believes he will be able to verify most of the prototypes for the programmable microgrid functions by then.
Zhang called advances in energy storage a “key component” that could improve the way microgrids control and distribute power. Energy storage can help stabilize and improve the resilience of microgrids.
He is eager to work with Esther Takeuchi, who has dual appointments at Stony Brook University and Brookhaven National Laboratory, not only on microgrid technologies but also on renewable integration in the transmission grid.
Zhang appreciates SBU’s reputation in physics, applied math, computer science and electrical and computer engineering. When he was young, he said he also heard about and saw Chen-Ning Yang, whom he described as a model and legend.
“I feel proud and honored to be working at Stony Brook where Dr. Yang taught for more than three decades,” he stated in an email.
In his lab, Zhang has six doctoral students, one visiting doctoral student and two master’s students. A postdoctoral researcher, Yifan Zhou, who worked with him at the University of Connecticut, will soon join his Long Island lab.
Zhang, who earned doctorates from Tsinghua University and the University of British Columbia, brought along a few grants from the University of Connecticut where he held two distinguished titles.
Zhang has “high expectations for the people who work for him,” Peter Luh, a board of trustees distinguished professor at the University of Connecticut, explained in an email. “However, he is considerate and helps them achieve their goals.”
Zhou, who comes from Tsinghua University, is working with him on stability issues in microgrids to guarantee their performance under any possible scenario, from a major storm to a cyberattack.
Zhang is working with Scott Smolka and Scott Stoller, both in the Computer Science Departmentat Stony Brook, on resilient microgrids
“We are planning to use simulations and more rigorous methods for formal mathematical analysis of cyberphysical systems to verify resiliency properties in the presence of fault or attacks,” said Stoller who described Zhang as a “distinguished expert on electric power systems and especially microgrids. His move to Stony Brook brings significant new expertise to the university.”
The Stony Brook scientists have created an exercise in which they attack his software systems, while he tries to ensure its ongoing reliability. Zhang will develop defense strategies to guarantee the resilience and safety of the microgrids.
Zhang was born in Shandong Province in China. He is married to Helen Wang, who works for a nonprofit corporation as an electrical engineer. The power couple has three sons: William, 13, Henry 10, and Benjamin, 8. They are hoping their sons benefit from the public school system on Long Island.
Zhang’s five-year goal for his work involves building an institute for power engineering, which will focus on microgrids and other future technologies. This institute could have 20 to 30 doctoral students.
An ambitious researcher, Zhang would like to be the leader in microgrid research in the country. “My goal is to make Stony Brook the top player in microgrid research in the U.S.,” he said.
Meng Yue, scientist in the Sustainable Energy Technologies Department at Brookhaven National Laboratory who has been collaborating with Zhang for over five years, anticipates that Zhang’s research will help consumers.
“As New York State has more aggressive renewable portfolio, I believe the research achievements will soon advance technologies in the power grid application,” he said.
A patient comes rushing into the emergency room at a hospital. He has numerous symptoms and, perhaps, preexisting conditions, that the staff gather together as they try to stabilize him and set him back on the path toward a healthy life.
Emergency room protocols typically involve testing for the function of major organs like the heart, even as a patient with diabetes would also likely need a blood sugar test as well.
For a specific subset of patients, hyperkalemia, in which a patient has potentially dangerously elevated levels of the element potassium, may also merit additional testing and treatment.
Adam Singer with his son Daniel. Photo by Michael Beck
In a recent study in the American Journal of Emergency Medicine, Adam Singer, a professor and vice chair for research at the Department of Emergency Medicine at the Renaissance School of Medicine at Stony Brook University, found that mortality rates were cut in half when doctors corrected for high levels of potassium.
“This study was focused on what we could do” to help patients with hyperkalemia, Singer said. “We always knew that rapid normalization was important, but we did not have the evidence except for anecdotal cases.”
Examining about 115,000 hospital visits to the Stony Brook Emergency Department between 2016 and 2017, Singer and his colleagues found that the mortality rate fell to 6.3 percent from 12.7 percent for patients whose potassium level was normalized.
Singer is “tackling a topic which is very important, which is life threatening and for which there is no clear standard,” said Peter Viccellio, a professor and vice chairman in the Department of Emergency Medicine at the Renaissance School of Medicine at SBU.
Viccellio said Stony Brook has become “more conservative over the last couple of years in treating patients with lower levels” of potassium.
One of the challenges with hyperkalemia is that it doesn’t usually come with any tell-tale symptoms. Emergency room doctors can’t determine an elevated level of potassium by looking at a patient or by hearing a list of symptoms.
Sometimes, people with hyperkalemia show weakness, nausea or vomiting, but those three conditions are also present in numerous other medical challenges.
Singer said not all the patients died directly from hyperkalemia. Most people with hyperkalemia have significant co-morbidities that put them at risk from other causes. Nonetheless, the higher level of mortality for patients above a threshold for potassium suggests that evaluating patients not only should include an awareness of the amount of this element in the blood, but also a clear set of guidelines for how to reduce it.
“This strengthens the need to call for more evidence-based studies to figure out the best and most effective therapies,” Singer said. “The higher the level of potassium, the greater the urgency for rapid correction,” he added.
Some hospitals may be using point-of-care tests and newer medications, especially new potassium binders. These treatments, however, have not been studied in large numbers yet.
As the population ages, more chronic disease patients take medicines that affect potassium levels. This, in turn, increases the risk of hyperkalemia, in part because chronic conditions like diabetes are so common. This risk extends to people who are obese and are developing diabetes.
On the positive side, Singer said some hospitals are using rapid point-of-care testing and, when they discover evidence of higher potassium, are using a new class of medications that treats the condition.
While the urgency for emergency room attendants is high enough to add potassium tests, especially for vulnerable patients, Singer does not believe that first responders necessarily need to add these tests to their evaluations on the way to the hospital. Such testing might be more urgent in rural areas, where transportation to a medical facility would take more time.
“Generally, such testing is not going to make a big difference” because patients will arrive at the hospital or medical facility before hyperkalemia becomes a contributing factor in their health, said Singer.
Changing a person’s lifestyle to lower the risk of hyperkalemia can be difficult because diets that are low in potassium are “hard to follow,” he said. Additionally diets that are low in potassium are often “lacking in other important food contents.”
Patients who are prone to hyperkalemia include people who are dehydrated, have kidney disease and missed a dialysis treatment, or are taking medications that can, as a side effect, boost the amount of potassium.
Generally, people don’t suddenly develop a high risk for hyperkalemia without any past medical history that suggests they are susceptible to it.During annual physicals, doctors customarily test for the level of potassium in the blood.
In terms of the total emergency room population, about 1 percent have higher potassium. During the years of the study, 308 patients had elevated potassium levels that remained high, while 576 had potassium levels that were high, but that were stabilized through treatment.
Higher potassium levels don’t necessarily require immediate treatment, in part because of a person who vomited several times might be getting fluids that restore the potassium balance
As director of research, Singer balances between his clinical responsibilities and his interest in conducting scientific research. When he sees an issue in the clinic, he can go back to the lab and then translate his research into clinical practice.
Viccellio said Singer is “internationally renowned” as a researcher and that he was a “superstar from day one.”
Singer’s primary interests are in acute wound care and burns. He has recently been studying a new, minimally invasive, nonsurgical technique to remove dead tissue after burns that involves an enzymatic agent and has been involved in several promising clinical trials of this technique.
Viccellio said Singer has done “fantastic work” on cosmetic repair of facial lacerations. Viccellio also suggested that Singer was “like the Bill Belichick” of research, helping numerous other people who went on to become research directors at other institutions.
A resident of Setauket for the last quarter of a century, Singer and his wife,Ayellet, have three children. Following in his father’s footsteps, his son Daniel is finishing his residency in emergency medicine at Stony Brook.
While Singer was born in Philadelphia and lived in Israel for part of his life, including during medical school, he has roots on Long Island. His grandparents originally lived in Ronkonkoma. Singer Lane in Smithtown, which was named after his realtor grandfather Seymour Singer, includes the one-room schoolhouse where Walt Whitman was a schoolmaster.
As for his work on hyperkalemia, Singer is pleased with the way he and his colleagues at Stony Brook have contributed to an awareness of the dangers of this condition. “We are identifying these patients and treating them,” he said.
In a Q&A with TBR News Media, Carol Gomes, interim chief executive officer at Stony Brook University Hospital, discusses a variety of topics including patient safety, quality control and curbing infections. Here is what she had to say.
1. Being the interim chief executive officer at the hospital, how important is patient safety andquality control to the day-to-day operations?
Stony Brook Medicine physicians and staff are committed to providing high-quality, safe patient care.
SBU Hospital CEO Carol Gomes discusses what the hospital is doing to reduce infection potential. Photo from SBU Hospital
Quality and patient safety is priority number one, and we focus on safe patient care every day. The Stony Brook Medicine team convenes a safety huddle that is part of the day-to-day operations in every area, which includes critical leaders from all over the hospital.
We start the day with approximately 35 care team members from nursing leadership, physician leadership and operational leadership who report on important safety or quality opportunities.Our huddles are highly structured meetings that allow the hospital to focus on process changes with direct follow-up. This drives accountability to help ensure that adequate safety measures are in place for our patients at all times.
2. Interim SBU President Michael Bernstein mentioned to us that you were making an effort to curb infections at the hospital among other things. Could you discuss some of the initiatives you’ve been implementing to improve in that area?
Stony Brook University Hospital has three primary strategic quality priorities — clinical outcomes, patient safety and the patient experience.
Proactively, Stony Brook works to provide safe and effective care to every patient via our patient safety work groups. These groups analyze processes, review relevant data and implement process changes to enhance patient safety and prevent patient harm.
The vast majority of projects and improvement efforts are aimed at reducing hospital associated infections. There are teams that implement best practices for CLABSI, or central line associated bloodstream infections; hand hygiene; CAUTI, or catheter-associated urinary tract infections; C. diff, or Clostridium difficile infections; SSI, or surgical site infections; and sepsis.
Working groups incorporate real-time data to implement best practices to ensure hospital units continue to drive improvement efforts in achieving patient safety goals.
3. In general could you talk about the threat of infections to patients at hospitals? Most people view hospitals as a place of recovery and necessarily don’t think of other germs, sick people around them. Can you speak on that and the challenges you and others face?
As a matter of standard practice, the hospital adheres to rigorous infection control guidelines every day to ensure a clean environment for patients, staff and visitors. These practices are especially important during the flu season.
Being within the close quarters of a hospital, there is an increased incidence of transmission for infections. Many patients have recent surgical wounds, IVs and other catheters placing them at higher risk of infection. These risks may be enhanced by the acquisition of an infection from a visitor.
Family members and other visitors who suspect they may have the flu or other viruses are advised to not visit the hospital.
To lessen the spread of the flu virus, hand hygiene and attention to reducing the effects of droplets from respiratory illnesses such as the flu can enhance patient safety.
Hand washing prevents infection. It is one of the most important actions each of us can implement before and after every encounter with a patient.
The goal is to minimize that transmission while the patient is in the hospital.
4. Other practices/guidelines at the hospital?
The flu virus most commonly spreads from an infected person to others. It’s important to stay home while you’re sick, not visit people in the hospital and to limit close contact with others.
Visitors should wash their hands before entering a patient room and after seeing a patient, whether or not there is patient contact.
As added protection, patients who have been identified as having infections are isolated appropriately from other patients in order to prevent accidental spread.
Therefore, if a patient has the flu or flulike symptoms, the hospital will place them in respiratory isolation. Likewise, a patient with measles or chicken pox is kept in appropriate isolation.
Visitors may be asked to wear masks on certain units.
5. How do patient safety grades affect how the hospital looks to improve
its quality?
Stony Brook University Hospital supports the public availability of quality and safety information about hospitals. We are constantly looking for ways to improve and ensure the highest quality of care.
There is a wide variation of quality reports with different methodologies and results.
Clinical outcomes define our success as a hospital. Better clinical outcomes means we’re taking better care of our patients. Stony Brook Medicine initiated a major initiative to improve clinical outcomes. We have multidisciplinary groups improving outcomes in the following areas:
•Increasing our time educating patients prior to their discharge in order to prevent hospital readmissions.
•Improving the care of our patients receiving surgery to reduce postoperative complications.
•Enhancing the diagnosis and care of patients with diabetes.
•Improving the speed of diagnosis and treatment of sepsis.
In short, great effort is expended in identifying opportunities for improvement with a detailed and focused approach on enhancing patient outcomes.
While the risk from the new deadly coronavirus that has closed cities in China remains low in New York, Long Island hospitals, including Stony Brook, are working with the New York Department of Health to prepare in case it makes its way to the New York area.
The respiratory virus, which originated at a seafood market in Wuhan Province in China during contact between humans and an animal that reportedly could have been a snake, has claimed the lives of 132 people as of Jan. 29. The virus has spread to three states, with single cases in Seattle, Washington, and Chicago, Illinois, and two cases in California.
The reported deaths from the virus are all in China, although people have also tested positive for coronavirus in countries including Australia, Canada, France, Japan and Vietnam, among others.
As of earlier this week, New York State had sent samples for nine people to the Centers for Disease Control and Prevention for testing. Four samples tested negative, while the state is awaiting results for the other five.
A Q&A withSusan Donelan, Medical Director of Health Care Epidemiology, Stony Brook University Hospital, About the New Coronavirus
1. Is the outbreak plan for this new coronavirus any different than the plan for SARS or MERS at Stony Brook?
The 2019 novel coronavirus (2019-nCoV), a new virus that causes respiratory illness in people and can spread from person to person, shares a lot of similarities to other coronaviruses we have seen such as SARS and MERS-CoV. At Stony Brook Medicine, our teams are incorporating best practices from the Pandemic Influenza Plan. These practices are especially important during the flu season.
2. Is everyone in the emergency room taking a history on admission, particularly for people presenting with respiratory infections and a fever, that includes questions about travel to China?
As a matter of standard practice for many years, the hospital has asked all patients with any influenza-like illness [ILI] about recent travel history and is well versed in obtaining this information. Additionally, regardless of the presence or absence of travel, any patient presenting with an ILI immediately will be given a surgical mask to place over the nose and mouth, in order to limit the spread of any respiratory pathogen they may be harboring.
3. How much space could Stony Brook make available if the hospital needed to isolate people who might have this virus?
Stony Brook Medicine has already performed a walk-through of our facility to identify where patients could be cohorted if there were suspicions for this illness, and should they need hospitalization. As per the [CDC], people confirmed to have the 2019-nCoV infection, who do not need to be hospitalized, can receive care at home.
4. What is the current recommended treatment plan if someone either has or is suspected to have this virus?
Currently, there is no vaccine available to protect against 2019-nCoV and no specific antiviral treatment is recommended for the infection. People infected with 2019-nCoV should receive supportive care to help relieve symptoms.
“These five individuals remain in isolation as their samples are tested at CDC,” Gov. Andrew Cuomo (D) said in a statement. “While the risk for New Yorkers is currently low, we are still working to keep everyone informed, prepared and safe.”
China has been working to contain the virus by enforcing lockdowns in cities like Wuhan. Indeed, an unnamed Stony Brook scientist, who was visiting his family, has been unable to leave China to return to Long Island. Through a spokeswoman, Stony Brook said it is grateful for the help of Sen. Chuck Schumer (D-NY), the State Department and the university community in trying to bring him home.
When he returns to the United States, the professor will remain in quarantine until he could no longer be a carrier for the virus.
Area hospitals, meanwhile, are watching carefully for any signs of coronavirus.
“There are procedure plans in place in every hospital,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases in the Department of Medicine at Stony Brook University’s Renaissance School of Medicine. “There is always a concern when these outbreaks are announced.”
At this point, however, the World Health Organization has not declared the outbreak an emergency. The CDC has classified the new coronavirus threat level as “low.”
The coronavirus, called 2019-nCoV, is in the same family as sudden acute respiratory syndrome and the Middle East respiratory syndrome. The initial mortality rate from the current coronavirus is lower than the 10 percent rate for SARS, which spread in 2002, or the 30 to 35 percent rate from MERS, which started in Saudi Arabia in 2012.
The timing of the virus is challenging because the symptoms are similar to those for the flu, which has become more prevalent in New York and around the country this winter. Coronavirus symptoms, according to the CDC, include coughing, fever and shortness of breath.
While airports like John F. Kennedy Airport in Queens are screening people who arrive from Wuhan, efforts to determine whether they may be carrying the virus could be limited, in part because the incubation period could be as long as two weeks, during which time an infected person could be contagious.
Infectious disease experts suggested practicing the kind of hygiene that would reduce the likelihood of contracting the flu. This includes: washing hands for at least 20 seconds, using hand sanitizer and maintaining a distance of about 3 feet from anyone who has the sniffles or appears to be battling a cold. Infectious disease experts also suggest cutting back on handshakes, especially with people who appear to be battling a cold.
“If you have immunocompromised people, they should be extra careful,” Fries said, adding that the CDC, which has been regularly updating its web page, www.cdc.gov, has been working tirelessly with national and state health officials to coordinate a response to this virus, wherever it hits.
“The New York State Department of Health and the CDC need to be praised for all the work” they are doing, she said. “They have a task force that doesn’t do anything else but prepare for patients coming from outbreak areas.”
Scientists around the world have also been working to develop a vaccine for this new virus. According to a recent report in The Washington Post, researchers anticipate developing such a vaccine in as little as three months, which is considerably shorter than the 20 months it took to develop a vaccine for the SARS virus. The Post, however, suggested that the development of a vaccine would require testing before it received approval.
Fries said the concern about the coronavirus comes less with the current death toll than it does with the effect as it continues to spread.
“It’s important to see how far it spreads and what the real mortality is,” which is tough to track because the outbreak is still at the beginning and scientists and public health officials are still processing new information, she added.
Stony Brook University Interim President Michael Bernstein during the school’s State of the University address in October 2019. Photo from Stony Brook University
Stony Brook University interim president Michael Bernstein has officially withdrawn his name for consideration in the search for the next SBU president.
Bernstein made the difficult decision “after considerable reflection,” according to an email statement from SBU.
“As he considered his future career options, he felt he needed the freedom to pursue external professional opportunities, without the complication of being an internal candidate at Stony Brook,” the statement read. “Michael has stated that he has been enormously impressed with, and inspired by the excellence of the faculty, staff, and students throughout Stony Brook’s campuses. It is his and the cabinet’s expectation that we will continue to work together as a team over the course of this next semester to move forward on all of our key goals.”
The interim president took over the reins at the university after former SBU President Dr. Samuel L. Stanley Jr. exited the position Aug. 1, 2019. In May of 2019, it was announced that Stanley would take on the role of president at Michigan State University in August that year.
In June of 2019, the State University of New York Board of Trustees approved Bernstein as interim president. Previously, Bernstein had served as provost and senior vice president for Academic Affairs as well as professor of business, economics and history at SBU since 2016.
During an exclusive interview with TBR News Media in August, Bernstein said he had been originally planning to step down as provost and move to San Diego. When Stanley announced he was leaving, he was asked if he would consider the interim role. During the interview, when questioned if he would consider staying permanently, Bernstein said he had an open mind.
“Let’s see if I like the job and more importantly let’s see if the job likes me and we’ll go from there,” Bernstein said at the time.
The news came as a surprise to members of the Three Village Civic Association, who were aiming to create a stronger relationship with the university, and TVCA 1st Vice President George Hoffman said the group was disappointed.
“Michael Bernstein was an affable and outgoing person,” he said. “The first thing he did when appointed interim president was to reach out to all of the community organizations and invite us for breakfast to discuss how we can improve the relationship between the university and the community.”
Hoffman said the civic association “had great hopes for future relationships under Bernstein.” It was something they felt like they didn’t have with the previous administration.
“It is our hope that the search committee will select a candidate that has the same understanding of the importance of community partnership as Michael Bernstein,” he said.
In September, SUNY announced a search committee that includes faculty, staff, Stony Brook Foundation members, students, administration, alumni and Stony Brook Council members. To aid the search, the committee set up the email address [email protected] for comments and suggestions to be submitted.
U.S. State Sen. Ken LaValle announced he would not be running for re-election Jan. 10. File photo by Kevin Redding
Why have you decided this term would be your last?
I don’t know, it just feels right. If I can put in place something at [Stony Brook University], then I can retire knowing we’re in a good place.
I look forward to spending more time with my wife and family, and less time driving on the Thruway.
I would like to do something academic — it’s a way of looking at things through a different lens.
Would you look to work at Stony Brook University?
That would be my choice. I would like to do something that’s always been on my radar — some kind of think tank, look at it in an academic way. My thoughts on generations, what is the difference between one generation to another. We know the events of WWII shaped what was called the greatest generation. But then there are millennials — who are millennials? You’re a millennial [he said, talking to me, a 25-year-old.] How are your thoughts shaped by your generation?
Some have said the climate of partisanship up in Albany has factored into your decision.
My personality has been to not get involved in that kind of stuff, I try to be kind and productive — there’s no doubt things have changed in the Legislature. I think you’ll see more people say it’s not a positive place — that’s how you start to lose good people. People will say, “Who the hell needs this?”
What are your plans for your last year in office?
I want to make sure all the preservation stuff is in place. That’s the kind of thing most near and dear to me. I want to leave things with the university and Brookhaven National Lab in a good place … I’m very focused, it’s always been 1st District first.
Does the preservation you’re talking about include the hundreds of acres over by the Shoreham Nuclear Power Plant?
Yes, absolutely.
What other things are you working with on preservation, what about the university are you currently engaged with?
I want to make sure that work we have started over at the Gyrodyne site keeps moving forward, it’s linked to the economic vitality of the area. I’m meeting with union representatives, talking about the sewage treatment plant, talking about the 8-acre parcel that would go on there. We got to have further discussions about that project.
Do you have any misgivings about the Gyrodyne plans?
I’ve got to have further discussions. I want to make sure I have the opportunity to talk to people at the university, I want to make sure where the sewage treatment plant is going is going to be accepted in the community.
Do you have any advice for whoever ends up taking over the district? What qualities do you feel like the new senator will require?
I will work with that person, whoever it is in November, whatever party. I will try to help them, work with them. No. 1, they’ve got to have an understanding of who they’re representing. There is a large group that thinks the environment is very important. Whoever is going to replace me will have to have that mindset or have a background in it.
It’s a big district, and there have been very few things I have missed. Whoever comes in will have to be very much involved in local events. Just look at Fishers Island, it’s closer to Connecticut, but it’s in the Town of Southold. There are 300 people living there, but you know, those people are just as important as any other part of the 1st District. They need to have an interaction with the people of the district.
I think right now the Senate majority, the Democrats, tend to represent New York City and New York City issues. We need someone who is going to fight for suburban and rural interests.
Though you still have a year left in office, how do you feel the shape of the district is in?
My personality has always been one to get things done. The district will be left in as good of a shape as can be.
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