Mark J. Adams, MD, MBA, FACR Elected Treasurer of the Medical Society of the State of New York


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

Mark J. Adams, MD, MBA, FACR Elected Treasurer
of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians 

Westbury, NY—May 8, 2020— Dr. Mark J. Adams was elected Treasurer of the Medical Society of the State of New York on May 7. A fellowship trained board-certified Radiologist, he is Professor of Clinical Imaging Sciences at University of Rochester Medical Center.

A graduate of Lehigh University, Dr. Adams received his Doctor of Medicine degree from the University of Rochester School of Medicine and Dentistry. He completed an internship in surgery at Barnes Hospital at Washington University in St. Louis, Missouri, a radiology residency at Rochester General Hospital, and a fellowship at the University of Rochester. He is certified by both the American Board of Radiology and the National Board of Medical Examiners.

In addition, Dr. Adams received an MBA from the William E. Simon School of Business and Administration at University of Rochester.

An active member of MSSNY since 2000, Dr. Adams served as the 7th District Councilor from 2011-2017. He currently serves as Commissioner of the Medical Education Committee, Vice Chair of the Legislative and Physician Advocacy Executive Committee, and member of the Collective Negotiation and Implementation Committee and the Nominating Committee. He also serves as Treasurer of the MSSNY Board of Trustees.

Dr. Adams is a New York Alternate Delegate to the American Medical Association and an active member of the Monroe County Medical Society, which he served as President in 2010.

As an active member in several radiological societies, Dr. Adams served on the Council Steering Committee of the American College of Radiology; President of the New York State Radiological Society; and President of the Rochester Roentgen Ray Society.

In 2012, Dr. Adams received the JACR Award for Recognition of Exceptional Manuscript Review from the American College of Radiology. He has been a Reviewer for the American Journal of Radiology since 1997.

An active member of his community, he currently serves in the ServNY Monroe County Medical Corps and the New York State CMS Carrier Advisory Committee.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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Joshua M. Cohen, MD, MPH, FAHS, Elected Assistant Secretary of the Medical Society of the State of New York


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MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

Joshua M. Cohen, MD, MPH, FAHS, Elected Assistant Secretary of the
Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Westbury, NY—May 8, 2020— Joshua M. Cohen, MD, was elected Assistant Secretary of the Medical Society of the State of New York on May 7. Dr. Cohen is Senior Director, Global Medical Therapeutic Area Lead for Migraine & Headache at Teva Pharmaceuticals.

A graduate of Harvard University, Dr. Cohen received his medical degree from New York University School of Medicine and completed his neurology residency at Columbia University’s Neurological Institute. Additionally, he received a Masters of Public Health from the Columbia Mailman School of Public Health. He completed his headache fellowship at The Headache Institute and a mini-fellowship in pediatric headache at Cincinnati Children’s Hospital. Board certified in both Neurology and Headache Medicine, he was chosen as a Super Doctors® in 2013, a New York Rising Stars™ in 2014 and a Castle Connolly America’s Top Doctors™ in 2015.

An active member of organized medicine for over 20 years, Dr. Cohen currently serves as MSSNY’s Commissioner for Public Health, and previously served as President of the New York County Medical Society. He has served the American Medical Association in a variety of leadership positions, including Chair of the Medical Student Section and Delegate to the House of Delegates as a member of the New York State Delegation.

Dr. Cohen has worked extensively with non-profits dedicated to improving public health. Since 2013, he has served on the Board of Directors of the American Medical Association Foundation and served as President of the Foundation 2017-2018. He was a founding Board member of the Nan Lightstone Foundation, whose mission is to support research and public education on infectious diseases. He served a two-year term as Chair for Trevor Project NextGen, supporting that organization’s work to provide suicide prevention and crisis intervention services to LGBTQ youth. Additionally, he was founder of Adolescents in Medicine at New York University, a program which encourages minority adolescents to pursue careers in healthcare fields, and he is also a former Albert Schweitzer Fellow.

Dr. Cohen has published original research and book chapters on headache disorders, with a research focus on patients with difficult-to-treat migraine. He is the recipient of multiple awards and accolades, including the American Headache Society (AHS)/Merck US Human Health Scholarship Award, the Arnold P. Gold Foundation Humanism and Excellence in Teaching Award, and the Harvard University Derek Bok Center Teaching Award.

Dr. Cohen lives in Manhattan with his husband, Keith, son Leo, and two dogs, Snax and Treatz.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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Maria A. Basile, MD Elected Vice Speaker of the Medical Society of the State of New York


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

Maria A. Basile, MD Elected Vice Speaker
of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians 

Westbury, NY—May 8, 2020— Maria A. Basile, MD was elected Vice Speaker of the Medical Society of the State of New York on May 7.  Dr. Basile is Chief Medical Officer at US Family Health Plan-St. Vincent’s (a TRICARE Prime Option) in New York City. Dr. Basile oversees and guides the Plan’s Quality Management and Improvement activities and initiatives. Additionally, she provides clinical guidance as US Family Health Plan’s senior clinical staff person.

From 2012-2019, Dr. Basile served as Assistant Vice President, Medical Affairs at Mather Hospital – Northwell Health, where her responsibilities included professional credentialing, physician engagement, medical staff quality improvement, and leadership development.

Prior to transitioning to Hospital Administration, Dr. Basile was a Colorectal Surgeon in private practice. She is a Diplomate of the American Board of Quality Assurance and Utilization Review Physicians, and is Board Certified in Health Care Quality Assurance, with specialty certification as a Physician Advisor. Dr. Basile has lectured nationally on physician wellness and resilience, medical ethics, and practice transformation.

cum laude graduate of Georgetown University, Dr. Basile earned her Medical Degree at Georgetown University School of Medicine. She completed a General Surgery residency at Mercy Catholic Medical Center in Philadelphia and a Colon and Rectal Surgery residency at St Vincent’s Medical Center in Erie, PA.  She is a graduate of the United Hospital Fund/Greater NY Hospital Association’s Clinical Quality Fellowship Program, and received a Master’s in Business Administration from Adelphi University in Garden City, NY.

Dr. Basile is on the Core Faculty at Stony Brook University Renaissance School of Medicine’s Center for Medical Humanities, Compassionate Care and Bioethics, where she teaches medical school and graduate-level courses in Literature and Medicine.  A physician-poet, she is author of Minimally Invasive: Poems from a Life in Surgery.  Her poems and articles have been published in Journal of the American Medical Association, Touch: the Journal of Healing, and The Pharos.

An active member of MSSNY, Dr. Basile currently serves as the Commissioner of Communications and previously served as Suffolk County Councilor. Through her leadership efforts at the local and statewide levels, she has been appointed Vice Chair of the MSSNY Committee on Physician Wellness and Resilience, Co-chair of the MSSNY Committee on Women, and a Vice Chair of the MSSNY Committee on Quality. She is a Past President of the Suffolk County Medical Society.

Dr. Basile lives in East Setauket, NY, with her two college-aged children, George and Christina, and two puppies, Parker and Miles.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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Parag Mehta, MD Elected Vice-President of the Medical Society of the State of New York


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

Parag Mehta, MD Elected Vice-President
of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Westbury, NY—May 8, 2020— Internist Parag Mehta, MD was elected Vice President of the Medical Society of the State of New York (MSSNY) on May 7. Dr. Mehta is the Senior Vice Chairman of the Department of Medicine and the Chief Medical Information Officer at New York Presbyterian Brooklyn Methodist Hospital (NYPBMH). In addition, he is an Associate Professor of Clinical Medicine at Weill Cornell Medicine.

Dr. Mehta has been involved with the implementation of EHR at NYPBMH for the last 16 years and has helped the institution to reach HIMSS Level 7. In this role, he brings IT and clinicians together to improve the user’s experience based on the user’s input.

A graduate of NHL Medical College in Ahmedabad, India, Dr. Mehta completed his residency in OB/GYN at NHL Medical College and his residency in Internal Medicine at NYPBMH in Brooklyn, New York. He is Board Certified in Internal Medicine, Hospice and Palliative Care  and Integrative and Holistic Medicine. He has completed courses in Health Information Technology from Cornell University and Artificial Intelligence from MIT Sloan School of Management.

An active member of organized medicine, Dr. Mehta is the Governor for the New York Chapter of the American College of Physicians (NYACP) for Brooklyn, Queens and Staten Island. In addition to MSSNY and NYACP, he is a member of AMA, Kings County Medical Society, American Association of Physicians of Indian Origin and Indian Medical Association.  In 2011, NYACP awarded him its highest honor, the Laureate Award, in recognition of his extraordinary contributions in the areas of governance, quality, public policy and education. As a Physician Wellbeing Champion, he promotes wellness and engages discussion through grand rounds.

Dr. Mehta’s many contributions to MSSNY include service as Assistant Treasurer, Commissioner of the Membership Division, Chair of the Future Task Force for Infrastructure/Organization, Chair of the International Medical Graduate Committee, and Young Physician Councilor. He presently serves as Councilor for Kings and Richmond County and as a New York Alternate Delegate to the American Medical Association.

Dr. Mehta lives in Manhasset Hills with his wife, Isha Mehta, MD, who is Chief of Gynecology at Elmhurst Hospital and is a founder of “A Stitch in Time,” an organization that treats gynecological conditions at no cost to women around the world. They have two daughters, Ruju, an environmental engineer, and Setu, a pre-med student at Harvard College.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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William Latreille, MD Elected Speaker of the Medical Society of the State of New York


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

William Latreille, MD Elected Speaker
of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Westbury, NY—May 8, 2020— Internist William Latreille, MD, was elected as Speaker of the Medical Society of the State of New York on May 7.  He will continue to play an active role in the outpatient medical practice at the University of Vermont Health Network, Alice Hyde Medical Center in Malone, New York. He will also continue his internal medicine practice in Malone and at the Indian Health Center in Hogansburg, New York.

A graduate of LeMoyne College in Syracuse, Dr. Latreille earned his medical degree at SUNY Upstate Medical Center in Syracuse. He received his first and second years of Internal Medicine residency training at the University of Missouri Medical Center in Columbia, Missouri and finished his residency training at the Robert Packer Hospital/Guthrie Clinic in Syre, Pennsylvania.  He is board certified in Internal Medicine.

Dr. Latreille is a Fellow of the American College of Physicians and a specialist in adult and adolescent medicine.  He also has been designated as a Senior Aviation Medical Examiner (AME) by the Federal Aviation Administration (FAA) to perform flight physical examinations and issue aviation medical certificates for Class 1, 2 and 3 pilots.

Dr. Latreille served as 4th District Councilor for eight years and 4th District President for four years. He created, and continues to chair,  the Lake Placid Retreat—now in its 21st year—that is held each January for MSSNY Districts 3 and 4. He was appointed to the MSSNY Board of Trustees in 2012 and served as Board Chairman for 2015-16. 

In addition to his activities at MSSNY, Dr. Latreille is a member of the American Medical Association (AMA) and a member of the NY Delegation to the AMA. He is also a member and past president of the Franklin County Medical Society.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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Joseph R. Sellers, MD, FAAP, FACP, Elected President-Elect of the Medical Society of the State of New York


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

Joseph R. Sellers, MD, FAAP, FACP, Elected President-Elect
of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Westbury, NY—May 8, 2020— Joseph R. Sellers, MD, FAAP, FACP, was elected President-Elect of the Medical Society of the State of New York on May 7. Board Certified in Internal Medicine and Pediatrics, Dr. Sellers serves as Eastern Region Medical Director for the Bassett Healthcare network.

Originally from Buffalo, Dr. Sellers earned his BA degree from the University of Rochester and his MD degree from Georgetown University School of Medicine.  He completed a combined Internal Medicine and Pediatrics Residency Program at the Albany Medical Center.  He is a fellow of the American Academy of Pediatrics and the American College of Physicians.

An attending physician in Internal Medicine and Pediatrics at the Bassett Medical Center, Cooperstown, NY and the Cobleskill Regional Hospital, Dr. Sellers is an Assistant Professor of Clinical Medicine at the Columbia University College of Physicians and Surgeons, where he has served as a primary care clerkship preceptor for over twenty years.

Dr. Sellers has served medical missions in Haiti and Kenya and is a volunteer physician with the Boy Scouts of America. Dr. Sellers has been a trustee of the Cobleskill Regional Hospital for the past 20 years and served for 22 years on the Schoharie County Board of Health.

An active member of organized medicine since 1990, Dr. Sellers previously served MSSNY as Vice President, Treasurer, Assistant Treasurer and as Secretary. He served as MSSNY’s Third District Councilor from 2004-2010, and Third District President from 1998-2004.  Additionally, he served as Chair of MSSNY’s Political Action Committee from 2010 to 2019.  He was president of the Schoharie County Medical Society from 1990-1994.  Dr. Sellers lives in Cobleskill, NY with his wife, Kathleen.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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Bonnie Litvack, MD Elected President of the Medical Society of the State of New York


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

Bonnie Litvack, MD Elected President
of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Westbury, NY—May 8, 2020— Radiologist Bonnie Litvack, MD was elected President of the Medical Society of the State of New York today. Dr. Litvack is Director of Women’s Imaging at Northern Westchester Hospital, which is part of Northwell Health.

A cum laude graduate of Rensselaer Polytechnic Institute, Dr. Litvack earned her medical degree at Albany Medical Center. She completed both her Internal Medicine internship and her diagnostic radiology residency at Stony Brook University and a magnetic resonance imaging/body imaging fellowship at New York Hospital-Cornell Medical Center.  Dr. Litvack is certified in diagnostic radiology by the American Board of Radiology.

Under Dr. Litvack’s leadership, the Women’s Imaging Center at Northern Westchester Hospital has been acclaimed as a Breast Imaging Center of Excellence by the American College of Radiology. During her career, Dr. Litvack has received numerous awards and honors.

An active member of organized medicine, Dr. Litvack has served as MSSNY’s President-Elect, Vice President, Assistant Secretary, Assistant Commissioner of Public Health, Commissioner of Membership and  MSSNY’s Ninth District Councilor.  She has also served as president of the Westchester County Medical Society, the Westchester Academy of Medicine,  the New York State Radiological Society and as MSSNY’s Ninth District President. She is a delegate from New York to the American Medical Association and has served as a councilor to the American College of Radiology.

Dr. Litvack lives in Chappaqua with her husband, Craig Penn, and daughters Sydney, Haley and Carly.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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COVID-19 Update May 8, 2020


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Colleagues:

After literal and figurative March and April showers, we are ready for those May flowers! We have been living in what should be the realm of science fiction. This global pandemic has hit our house of medicine hard physically, emotionally, and financially. My thoughts and prayers are with all of you. I wish those that are sick a speedy recovery and those that have suffered the loss of a loved one my heartfelt sympathy.

During these trying times the ethics, courage, strength, ingenuity, and resilience of the physicians of New York have not waivered nor have the efforts of our medical society. We have spoken out about everything from needed equipment, needed protections both physical and legal to needed funding.  We have come together as a profession and rapidly mobilized, disseminated needed information, and helped our practices adapt to the current reality.  This has been in no small part due to the strong leadership and tireless efforts on the part of Dr. Art Fougner whose inspiring quotes and stories have been a light in the darkness.

As I humbly take the torch from Art, the seeds of change are beginning to take hold.  The talk is of re-imagining healthcare in our state. It is time to change– medical malpractice reform, an end to bureaucratic paperwork and hassles and a time for collective negotiation for physicians.  As we start this new decade it is time to end to health disparities and prioritize healthy equity. Let us imagine New York with a new distinction as the healthiest place to live and to practice medicine.

May the roses bloom in our gardens this year!  Happy Mother’s Day to all.

Bonnie Litvack, MD
MSSNY President


Governor Cuomo’s COVID-19 Briefing Notes for Today

GENERAL:
-Hospitalizations down to 8,196.
– Intubations down (-330).
– New hospitalizations flat (604), have been flat for a few days.
– IHME Projection model show cases decreasing over time, but still expects a
few hundred in June.
– Deaths since May 7: 216. 171 in hospitals, 45 in nursing homes

AIRPORTS:
– 3 Million Europeans flew into NY from December to March, none were screened
for the virus.
– Reiterated argument that an outbreak in one nation can be assumed to exist
in other regions as well.

UPDATES ON COVID-19:
– There are doubts of immunity despite the existence of antibodies, though
information continues to be updated.
– 73 reported cases of children with symptoms similar to Kawasaki disease.
– On Thursday, a 5-year old boy passed away from COVID-related
complications and other cases are being investigated as well.
– Gov urged parents to seek care if their child has a prolonged fever,
difficulty feeding, severe abdominal pain/diarrhea/vomiting, change in skin
color (pale, patchy, or blue), trouble breathing, chest pain, decreased amount
or frequency of urine, lethargy, irritability, or confusion.
– Infection rate is higher in minorities, affecting Hispanic/Latinos and
African-Americans the most.
– Have asked hospitals to provide information on new cases as a way
to better target state efforts.
– Majority of new cases are coming from minority communities. Gov says
this inequity will be addressed immediately, with new information to be
released in a couple of days.

CHILD VICTIMS ACT:
– Because of reduction in court services, window will be extended an additional
five months (Jan. 14).

PERSONAL OPINION:
– Gov feels we are ahead of the virus and “in control of our own destiny.”
Attributes success to distancing protocols. Again, urged for responsible
reopenings to ensure numbers continue to go down.

Q&A:

REOPENING:
– Gov says “nicest surprise” when reopening would be acting responsibly.
Reiterated a focus on factual data to best determine reopening and the actions
to be taken. Doesn’t believe downstate numbers will change enough in the next
few days to reopen.
– Gov wants to avoid any potential deaths from “responding to politics.”

UNEMPLOYMENT:
– On a remark that many jobs were lost, Gov, claimed to understand the
struggles many New Yorkers are facing now. “We have to get through,” he said. Gov
reiterated previous statement that health is most important.
– Said we will “figure out” the economics once the situation becomes more
manageable.
– DeRosa urged applicants to take matters online and only use the phone system
if there is a lack of access to internet. Granted $6.8 billion to 1.6 million
people in the last seven weeks.
– DeRosa reiterated that upgrades to the system were not necessary prior to
the outbreak, as well as the point that NYS has done more than other states to
help the unemployed.
– “Unemployment forfeit” days: DeRosa said this has come to their attention in
the last week and the state is working to fix the issue.

TESTING:

– Antibody testing is used as an indicator of infection rates. No action is
being taken after testing, Gov says data is used for statistical purposes.
– DOH Commissioner Zucker: Working with hospitals to develop tests and confirm quality of tests. Also added that NYS’s antibody test stands six standard deviations out, making it more accurate.


SMALL BUSINESS LOANS FOR PHYSICIANS

PLEASE TAKE THE NEW SURVEY!

In late April, Congress approved an additional $310 billion dollars for the Paycheck Protection forgivable loan Program (PPP) to assist small businesses, including physician practices. To date, the program has approved assistance to nearly 250,000 New York businesses in two different rounds of application periods.

The Congressional package also provided $75 billion more for the CARES Act Health Provider Relief Pool, to assist hospitals and physicians. This is in addition to $30 billion dedicated to physicians and hospitals, in early April, based on 2019 Medicare payments, and $20 billion was just made available to physicians and hospitals based on 2018 total patient revenue.

As with our first survey, MSSNY wants to gather data to determine how much New York physicians are benefiting from these new resources, to better guide our advocacy for further stimulus bills. Please help us evaluate this by taking a few minutes to fill out and submit the following Survey Monkey questionnaire.

Please take the survey here


COVID-19 Map – Johns Hopkins Coronavirus Resource Center


HHS Extends Attestation Time Period for CARES Act Relief Pool
The US Department of Health and Human Services (HHS) has extended the deadline for physicians and other healthcare providers to attest to receipt of payments from the CARES Act Provider Relief Fund and accept the Terms and Conditions. Physicians will now have 45 days, increased from 30 days, from the date they receive a payment to attest and accept the Terms and Conditions or return the funds. The AMA gives the example that, the initial 30-day deadline for providers who received payment on April 10, 2020, is extended to May 24 from May 9, 2020. With the extension, not returning the payment within 45 days of receipt of payment will be viewed as acceptance of the Terms and Conditions. For physicians, this is referring to payments from the $30 billion in Round 1 from this fund and $20 billion in Round 2 from this CARES Act relief fund (not the PPP).


More Details Regarding Empire BCBS Advance Physician Payment Program
As reported in the MSSNY e-news and Crain’s Health Pulse earlier this week, Empire BCBS (Anthem) is initiating a program to provide advance care payments to many of its network independent primary care and specialty care physician practices in New York State and across the country.  The goal of the program is to help these practices through this difficult period to remain available for patient care as we begin to transition back to a more regular schedule of patient care visits.  Advance payments would be paid back over a period of time.  Empire has begun outreach to physician groups that meet the criteria to be eligible for this program.  Further questions can be directed to Empire’s provider relations department (https://www.empireblue.com/provider/)


Malaria Drug Shows No Benefit in New Coronavirus Study
A new study finds no evidence of benefit from a malaria drug widely promoted as a treatment for coronavirus infection. Hydroxychloroquine did not lower the risk of dying or needing a breathing tube in a comparison that involved nearly 1,400 patients treated at Columbia University in New York, researchers reported Thursday in the New England Journal of Medicine.

Although the study is observational rather than a rigorous experiment, it gives valuable information for a decision that hundreds of thousands of COVID-19 patients have already had to make without clear evidence about the drug’s risks and benefits, some journal editors and other doctors wrote in an editorial. “It is disappointing that several months into the pandemic, we do not yet have results” from any strict tests of the drug, they wrote. Still, the new study “suggests that this treatment is not a panacea.”

President Donald Trump repeatedly urged the use of hydroxychloroquine, which is used now for lupus and rheumatoid arthritis. It has potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death.

The U.S. Food and Drug Administration has warned against its use for coronavirus infections except in formal studies. Doctors at Columbia tracked how 565 patients who did not get the drug fared compared to 811 others who received hydroxychloroquine with or without the antibiotic azithromycin, a combo Trump also has touted.

In all, 180 patients required breathing tubes and 232 died, and the drug did not seem to affect the odds of either. Patients given hydroxychloroquine were generally sicker than the others, but widely accepted methods were used to take that into account and still no benefit was seen for the drug.

Its use started within two days of admission for nearly all who received it. Some critics of earlier studies have said treatment may have started too late to do any good.

The study was funded by the National Institutes of Health, which has launched two of its own trials comparing hydroxychloroquine to placebo — the gold standard for establishing safety and effectiveness.

One study involves COVID-19 patients, and the other aims to see whether the drug can help prevent infections in health care workers exposed to the virus. Both got started in April. (Modern Healthcare, May 8)


This Week’s Legislative Podcast


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Hospitals and Doctors: Need $60 Billion in Direct Funding
New York state said Thursday that it needs at least an additional $60 billion in direct federal funding along with millions of dollars more from Medicaid and FEMA formula changes in the next coronavirus aid package being crafted in Congress.

New York’s massive request, which is part of the National Governors Association’s bid for $500 billion for all states and territories, would be spread over three fiscal years, unrestricted and could be used for revenue shortfalls, according to the association.

New York hospitals need additional direct federal funding, targeted to “hot spots” such as New York state, to meet the high cost of treating patients with COVID-19 amid huge revenue losses, the Healthcare Association of New York State said.

A top priority is to bolster New York State’s finances so that it does not have to cut state Medicaid funding by as much as 20% to 30%.The association seeks changes in formulas used to distribute health care funding, including tweaks to Medicare and Medicaid payment systems, that could be worth billions of dollars.

Meanwhile, doctors with private practices need greater access to small business loans and medical school loan debts should be forgiven for young physicians and residents, especially for those who have pitched in to treat the infected patients, said the Medical Society of the State of New York. (Newsday, Updated May 7)


Symptomatic Spread of SARS-CoV-2 in a Nursing Home
Neil M. Ampel, MD reviewing Arons MM et al. N Engl J Med 2020 Apr 24 Gandhi M et al. N Engl J Med 2020 Apr 24

More than half the residents who tested positive were asymptomatic at testing.

Nursing homes are now recognized as niduses of infection with SARS-CoV-2. On February 29, 2020, because of known COVID-19 in their area, a nursing home in King County, Washington, instituted enhanced infection control measures and soon identified a resident and staff member who were infected. This prompted a larger study culminating in two point-prevalence surveys of the residents. Full-time staff were also tested.

On the initial screen of 76 residents, 23 (30%) were positive on nasopharyngeal swab for SARS-CoV-2. Among those testing positive, 12 (52%) were asymptomatic. One week later, 49 who were initially negative were retested. Of these, 24 (49%) were positive and 15 (63%) were without symptoms. Of the 27 residents testing positive without symptoms, 24 (89%) later developed symptoms. Among 138 full-time staff, 26 (19%) tested positive. The doubling time of infection was 3.5 days. Fifteen residents (26%) died. There was no difference in the viral load of SARS-CoV-2 in samples from those with symptoms and those without symptoms. Viable virus was isolated from 6 days before to 9 days after symptoms developed.

COMMENT

This paper has multiple important takeaways. First, infection can spread rapidly and efficiently in a nursing home environment. Second, infection control methods that focus only on those with symptoms are inadequate, since there is likely ongoing transmission from patients without symptoms as well as from staff. As the editorialists point out, this asymptomatic transmission distinguishes SARS-CoV-2 from the related SARS-CoV-1. Last, early and repeated viral testing of residents and staff, particularly those without symptoms, is the key to control. CITATION(S):

Arons MM et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med 2020 Apr 24; [e-pub]. (https://doi.org/10.1056/NEJMoa2008457)

Gandhi M et al. Asymptomatic transmission, the Achilles’ heel of current strategies to control Covid-19. N Engl J Med 2020 Apr 24; [e-pub].

 (https://doi.org/10.1056/NEJMe2009758)


May 20, 2020 @ 7:30am Medical Matters CME Webinar Registration Now Open Mental Health and COVID-19 for Health Professionals

Register now for MSSNY’s next webinar related to the COVID-19 pandemic, Medical Matters: Mental Health and COVID-19 for Health Professionals.  Just like we need to take extra precautions to protect ourselves from the risk of being infected by COVID-19, we also need to be concerned about psychological risks for health professionals.  Faculty for this program is Craig Katz, MD.

Registration is now open for this webinar

To view the companion pieces to this webinar, be sure to go to https://cme.mssny.org and view Medical Matters: Coronaviruses 2020: COVID-19 An Evolving Story recorded on March 18, 2020, Medical Matters: Psychosocial Dimensions of Infectious Outbreaks recorded on April 1, 2020 and Medical Matters: COVID-19 for Office-Based Physicians: How to Handle Surge and Psychological First Aid recorded on April 29, 2020.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Health Care Workers Dealing With ‘Medical Burnout’ Amid Exhausting Pandemic
The pandemic has taken its toll on health care workers, leading many to experience medical burnout. Northwell cardiologist Dr. Evelina Grayver, who works in a COVID-19 ICU, says the trauma and stress can take a toll on medical staff. She says burnout has always- been a bullet to dodge, but the coronavirus has made it even tougher.

“At a certain point, we allow ourselves to be human and allow ourselves to feel the fear and the helplessness and the sense of desperation,” says Grayver. “Because if we don’t deal with it head-on, we are going into an era of anxiety depression, insomnia, post-traumatic stress disorder.”

Northwell Health has set up several resources for its medical providers who are feeling burned out, including outreach programs, counseling and setting up tranquility spaces where staff can take a few moments to regroup.

“We have ramped up our support services because everybody knows that people are under an enormous amount of stress and anxiety,” says Northwell Health Senior Vice President Dr. David Battinelli.

Along With support from clinicians, Northwell Health psychiatrist and Director of CPH, Dr. Jeff Selzer. says the signs of support from the community and sense of teamwork is keeping health care professionals emotionally strong.

“Strong teams, the sense of peer support, the sense of mission and how important it is for all of us to express gratitude to health care workers,” says Selzer.


Veterans Matters: Substance Use Disorder in Veterans Podcast
Check out MSSNY’s Veterans Matters newest podcast entitled Substance Use Disorders (SUDs) in Veterans. Dr. Thomas Madejski, Immediate Past President of MSSNY, discusses how to identify and diagnose substance use in veterans. Click here to listen.


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Sign Up to Receive Alerts From MSSNY’s Grassroots Action Center

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.orgThank you. (WILKS)

COVID-19 Update May 7, 2020

Do You Have a Story To Tell or a Photo To Share With Your MSSNY Colleagues? Send to Csouthard@MSSNY.org or Call 516-488-6100 Ext. 355!


COVID-19 Map – Johns Hopkins Coronavirus Resource Center


Gov. Cuomo’s Press Conference Thursday, May 7

GENERAL:
– Total hospitalizations down to ~8,600. Net change also down.
– Intubations are down.
– Number of new cases relatively flat (607). Gov says this has been a slow
downturn.
– Deaths since May 6: 231; 191 in hospitals; 40 in nursing homes.
– Top priority is protecting essential workers. Gov honors their courage and
efforts to take care of society.

TESTING:
– Have been “aggressively” testing essential workers: 25 downstate healthcare
facilities, over 27k employees.
– Found 12% of NYC healthcare workers tested positive (slightly lower
than general population, 19.9%).
– Shows that masks, gloves, and sanitizer have worked.

NOURISH NY:
– Gov said many farms have been particularly impacted by COVID-19, facing waste
and financial loss.
– Launched $25 million Nourish NY Initiative (funds 50 food banks). Wants to
continue this, urged philanthropies/foundations to help.
– Contact covidphilanthropies@exec.ny.gov
– 20,000 households will receive Nourish NY products within the next week.

REOPENING:
– Need to prioritize public health over the economy. No doubts that we will
reopen, Gov just wants to do so safely.
– Gov says leaders making decisions should be willing to participate in
anything they authorize.
– Reiterated that decisions must be made based on facts and data.

Q&A:
FINANCIAL ASSISTANCE:

– PAUSE to expire May 15, then will look at different regions to see where to
begin reopening. Economy will be starting at this point.
– Gov wants to ensure the most vulnerable and financially needy are protected.
He attributed moratorium on evictions, funding food banks, and more as relief
efforts. Hopes extension of moratorium can ease the anxieties of many.
– Gov is working on relief from the banks for landlords, as well as relief for
banks themselves. However, the state’s priority is protecting families from being evicted.
-Have overflow facilities across the state to take nursing home residents
that cannot be cared for.


Is Your Practice in Need of PPE? MSSNY Can Help!
Are you facing challenges obtaining needed PPE for your practice?

If you are a MSSNY member, please let us know if you would like MSSNY’s assistance in obtaining protective equipment, including N95 and KN95 masks.  MSSNY is working with vendors and the New York State Health Department to help physicians meet their PPE needs so that they can get back to treating patients.

Please be aware that some businesses promoting PPE availability have not been properly vetted, have provided substandard products and in some cases have not delivered on the ordered products.  Please contact mauster@mssny.org / pclancy@mssny.org / eskelly@mssny.org if you are a member and require MSSNY’s assistance.


New MSSNY Officers and Councilors Elected May 7, 2020
The Nominating Committee held a meeting on Thursday, January 30, 2020.  After careful consideration of the recommendations submitted by the district branches, county medical societies, the medical student, resident & fellow and young physicians sections, your Committee respectfully submits the following candidates for election on April 25 and 26:

Officers (Each for term of 2020-2021)

President                Bonnie L. Litvack, MD, Westchester
President-Elect        Joseph R. Sellers, MD, Schoharie
Vice-President         Parag H. Mehta, MD, Kings
Secretary                Frank G. Dowling, MD, Suffolk
Assistant Secretary Joshua M. Cohen, MD, New York
Treasurer                Mark J. Adams, MD, Monroe
Assistant Treasurer Howard H. Huang, MD, Jefferson
Speaker                  William R. Latreille, MD, FACP, AME, Franklin
Vice-Speaker          Maria A. Basile, MD, Suffolk

Councilors (Four for term 2020-2023)

First District            Adolph Meyer, MD, Kings
First District            David Jakubowicz, MD, Bronx
Fifth District            Barry Rabin, MD, Onondaga
Seventh District       Janine Fogarty, MD, Monroe

Councilor (One for unexpired term of Edward Bartels to 2021)

Eighth District          Mark Jajkowski, MD, Erie

Resident and Fellow Section Councilor (One-year term 2020-2021) – Raymond Lorenzoni, MD

Medical Student Section Councilor (One-year term 2020-2021) – Shireen Saxena, Monroe

Officers, Councilors and Trustees

Trustees (One Five-Year Term 2020-2025) – Thomas J. Madejski, MD, Orleans


Coronavirus Fear Prompting Avoidance of Healthcare, Poll Finds
Around 29 percent of U.S. adults said they have delayed or avoided seeking medical care due to concerns about contracting COVID-19, a new poll shows.

The poll, conducted by market research firm Morning Consult on behalf of the American College of Emergency Physicians between April 18 and April 20, surveyed a national sample of 2,201 U.S. adults.

Four survey findings:

  1. Sixty-three percent of respondents said they are “very” or at least “somewhat” concerned about wait times at healthcare facilities, and 59 percent expressed concern about receiving adequate care.
  2. Fifty-four percent of adults between 18 and 39 years of age said they have actively delayed or avoided seeking care due to COVID-19 concerns, compared to 59 percent of adults, ages 40 to 74 years.
  3. Around 80 percent of respondents said they are concerned about contracting COVID-19 from another patient or visitor if they need to go to an emergency room.
  4. Most respondents (73 percent) are concerned about overstressing the health care system when considering a trip to the emergency department. (Becker’s Hospital Review, Ap 29)

Look Out for COVID-19 Scams Directed at Physicians
Unfortunately, scammers are using the COVID-19 pandemic to try to steal your Medicare Number, personal information, and money. And they are using robocalls, social media posts, and emails to do it.

Remember, if anyone reaches out to get your Medicare Number or personal information in exchange for something, you can bet it is a scam.

·  Be on the lookout, so you can stop scams before they happen. Here are recent Coronavirus scams to watch for:

·  Robocalls offering you respiratory masks they will never send

·  Social media posts fraudulently seeking donations for non-existent charities, or claiming to give you stimulus funds if you enter your bank account information

·  Fake testing kits, cures, “immunity” pills, and offers for protective equipment

Remember this:

·  Medicare will never contact you for your Medicare Number or other personal information unless you have given them permission in advance.

·  Medicare will never call you to sell you anything.

·  Visit Medicare.gov/fraud for more information and tips on preventing Medicare scams and fraud.


Hackers Targeting Healthcare to Steal COVID-19 Info, U.S., U.K. Warn
Sophisticated hackers are targeting healthcare and medical research organizations to gain information about the novel coronavirus, according to U.S. and U.K. cybersecurity agencies.

The Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency and the U.K.’s National Cyber Security Centre in a joint alert issued Tuesday said they have found evidence that “(advanced persistent threat) actors are actively targeting organizations involved in both national and international COVID-19 responses.”

APT groups typically comprise hackers backed by a nation state. The CISA and the NCSC did not say whether the attacks they have identified were linked with specific countries.

Hospitals have already seen an uptick in cyber attacks trying to take advantage of the COVID-19 outbreak to spread malware. But the attacks warned of by the U.S. and U.K. cybersecurity agencies this week differ in that APT groups are frequently looking to steal intellectual property or sensitive data related to COVID-19 research.

Hackers affiliated with APT groups have looked to exploit healthcare organizations’ weak password practices, according to the agencies.

The CISA and the NCSC are investigating “large-scale password spraying campaigns” that have targeted healthcare entities in the U.S. and the U.K., as well as international healthcare organizations. In a password spraying campaign, a hacker will try to enter different commonly used passwords into many accounts to try to break into them.

“These attacks are successful because, for any given large set of users, there will likely be some with common passwords,” the alert reads.

Hackers have also been taking advantage of the shift to remote work by searching out vulnerabilities in virtual private network, better known as VPN, products.

The CISA and the NCSC warned that they are investigating multiple attacks against organizations involved in COVID-19 research, including against pharmaceutical companies, medical research organizations and universities. Those attacks may have been perpetrated to “steal sensitive research data and intellectual property for commercial and state benefit,” the agencies said.

To protect against cyberthreats, the CISA and the NCSC recommended organizations implement multi-factor authentication, update VPNs and set up security monitoring capabilities, among other mitigation tactics. (Modern Healthcare, May 6)


Q & A: What About Mild or Asymptomatic Cases of COVID-19?
Asymptomatic transmission has not only been confirmed in China, but recent modeling data found that mild or asymptomatic cases that went undetected (“undocumented”) accounted for 85% of total infections in the earliest stages of the outbreak. The study found these cases were less infectious on a per-contact basis, but because those individuals were not isolated, they infected more people in total.

The big unknown, however, is how common it may be for people to become infected but with symptoms too mild to seek treatment. Currently, detection is based on molecular testing, which is performed only on individuals who come into contact with the healthcare system. The prevalence of such mild or asymptomatic infections will not be known until an inexpensive serological test, detecting antibodies to the virus that signal previous exposure, is available for use with routine blood draws. Thus, the extent of exposure in the population may not be known for years.

How do you contract COVID-19?

Research points to droplet and fomite transmission, with recent data suggesting the virus can survive on surfaces such as plastic and stainless steel for up to several days. It can also survive in the air for a few hours, indicating it may also potentially be aerosol transmissible.

The virus may also be transmitted through the fecal-oral route, with research suggesting some patients develop gastrointestinal symptoms, and that the virus is shed through stool.

A small cohort study in China found the virus present in two patients’ tears, indicating it might be transmissible through eye secretions.

How infectious is the COVID-19 coronavirus?

Research from China found a similar viral load in symptomatic and asymptomatic patients, which may suggest patients can transmit the virus whether they have mild or severe disease.

Latest data from the World Health Organization estimated the “R0” as 2.0 to 2.5, meaning infected individuals transmit it to 2-2.5 others on average. By contrast, the R0 for measles is 12-18, while for seasonal influenza it is a little over 1.

How virulent is COVID-19?

According to JAMA, global mortality for COVID-19 is reported to be 4.7%, and about 1.7% of patients died in the first 141,000 cases in the U.S., though the authors emphasized this was not an accurate case-fatality rate due to the uncertain denominator.

CDC examined the first 4,200 U.S. cases, and found 508 (12%) of patients were hospitalized, and of those, 121 were known to be admitted to an intensive care unit, and 44 patients died. Similar to China, both hospitalization and mortality rates increased with increasing age, though this data indicated 20% of hospitalized patients and 12% of patients admitted to an ICU were ages 20-44. Nine patients ages 20-44 died, though in the entire group most deaths were among adults ages 65 and older.

Notably, however, mortality rates vary dramatically from one country to another, raising more questions about case-finding and record-keeping than there are answers.

What are the early symptoms of COVID-19?

In addition to fever, cough and shortness of breath, CDC now lists several other symptoms: chills, repeated shaking with chills, new loss of taste or smell, muscle aches, headache and sore throat.

Examining data from patients admitted in New York City, prior to respiratory symptoms, including about three-quarters presented with cough or fever, and almost 60% with shortness of breath. Gastrointestinal symptoms seem to be more common in U.S. patients, with about a quarter reporting diarrhea and 20% reporting vomiting.

It appears not all patients present with symptoms, with research out of Germany in February finding patients testing positive for COVID-19 despite being afebrile and otherwise normal-seeming.

How is COVID-19 diagnosed?

A patient is swabbed, then the sample is tested via reverse transcription polymerase chain reaction (RT-PCR) to determine presence of viral RNA.

The FDA recently authorized the first serology test to detect IgM and IgG antibodies under Emergency Use Authorization, for diagnosing COVID-19 infection in combination with other clinical and lab data.

What are the risk factors for more severe disease?

Reports from China indicate disease is much more severe in older patients, with the highest mortality rate among adults age 80 and older. Patients with other comorbidities are also the most at risk, with U.S. data finding hypertension and obesity were the most common chronic medical conditions among patients hospitalized with COVID-19, followed by chronic lung conditions, diabetes and cardiovascular disease.

Data out of New York City found obesity as a risk factor for mechanical ventilation. Patients requiring mechanical ventilation were also more likely to need vasopressors, and experienced other complications such as atrial arrhythmias and new renal replacement therapy.

What does severe disease look like?

JAMA detailed 21 patients from Washington state, 15 of whom needed mechanical ventilation. All 15 had acute respiratory distress syndrome, and eight developed severe ARDS by 72 hours. Vasopressors were used for 14 patients, though most patients did not present with evidence of shock, and seven patients developed cardiomyopathy. Mortality among this group was 67%, 24% remained critically ill and 9.5% were discharged from the ICU, as of March 17.

In New York City, a third of patients required intubation, and of these, 30% did not get supplemental oxygen, meaning they deteriorated quickly.

However, U.K. research indicated a lower proportion of COVID-19 patients in the critical care unit survived compared to patients with non-COVID-19 viral pneumonia (52.1% vs 77.8%, respectively).

How is the disease treated?

Treatment mainly consists of supportive care, according to CDC recommendations. The most common complications of severe disease include pneumonia, hypoxemic respiratory failure/ARDS, shock, multiorgan failure. Since pneumonia is common, IV antibiotic use has been widely reported, along with supplemental oxygen, with anecdotal reports of proning and ultimately, mechanical ventilation, including some patients who receive extra corporeal membrane oxygenation (ECMO).

Although corticosteroids were widely used in China, the CDC generally recommends against them except in patients with steroid-responsive comorbidities such as septic shock. “[P]atients with MERS-CoV or influenza who were given corticosteroids were more likely to have prolonged viral replication, receive mechanical ventilation, and have higher mortality,” whereas reports from China in COVID-19 were uncontrolled and observational, the CDC explained. Research indicates patients hospitalized with COVID-19 often develop blood clots, leading some international societies to call for patients to receive prophylactic anticoagulant treatment to prevent this complication.

What are the potential therapeutic options for treating the virus?

There are currently no approved therapies to treat COVID-19. The NIH released treatment guidelines, which noted both insufficient clinical data to recommend for or against use of both remedisivir and hydroxychloroquine and chloroquine. Specifically, the agency noted monitoring patients who receive HCQ for adverse effects, especially prolonged QTc interval. The FDA recently issued a warning about the heart risks of the drug. NIH also said there is insufficient clinical data to recommend use of convalescent plasma or hyperimmune globulin, as well as interleukin-6 inhibitors and interleukin-1 inhibitors. The agency recommended against the use of hydroxychloroquine plus azithromycin, lopinavir/ritonavir (Kaletra) or other HIV protease inhibitors, interferons and Janus kinase inhibitors.

What is the status of clinical trials for these potential therapies?

Remdesivir has been available for compassionate use. An interim analysis of a formal trial from the National Institute of Allergy and Infectious Diseases including data from U.S. patients found remdesivir met its primary endpoint in severe COVID-19 patients, significantly faster time to recovery versus controls, and trended towards a survival benefit. Manufacturer Gilead Sciences also reported topline results from a phase III trial comparing two dosing regimens in severe cases, but without a usual-care control group, showing a trend favoring a 5- versus 10-day treatment period.

Many hospitals have begun to use hydroxychloroquine or chloroquine, which is most commonly used to treat patients with malaria, as well as arthritis and systemic lupus erythematosus, although the supporting evidence is anecdotal at best. The FDA has issued an Emergency Use Authorization for hydroxychloroquine held in the National Strategic Stockpile, although that does not make COVID-19 an approved indication. Latest data from the U.S. found no difference in risk of ventilation the drug in male veterans with severe COVID-19.

A small case series in China found three of five patients treated with convalescent plasma were later discharged from the hospital, though questions about scaling this as a potential therapy remain. Some centers have also tried anti-cytokine agents such as tocilizumab (Actemra) but evidence of benefit over standard treatment remains scant. Controlled trials with tocilizumab are now underway, including one sponsored by drugmaker Genentech/Roche.

Sanofi and Regeneron announced a phase II/III trial for sarilumab (Kevzara), another anti-interleukin-6 agent, for patients with severe COVID-19.The Milken Institute has collated currently ongoing trials for COVID-19 interventions on its website.

What are the vaccine prospects?

Several companies and public health agencies have vaccines in development, including the National Institute of Allergy and Infectious Diseases. Phase I trials with vaccines are underway, with a timeline of 12-18 months for a vaccine to be ready for wide-scale deployment.

As of April 21, the Milken Institute counted 115 vaccine candidates in development, including six in phase I and five in phase I-II safety and efficacy studies in humans.

What is the prognosis for patients with COVID-19?

Older patients and those with other comorbidities are the most at risk, whereas the disease appears to be less severe among younger patients. U.S. data seems to indicate fewer children contract severe disease than adults, and hospitalization in this population is most common among infants and children with underlying conditions.

Research is starting to come from China that COVID-19 vertical transmission from mother to baby is possible, given several isolated case reports.

What are some potential complications of COVID-19?

Data from New York City indicated ST-segment elevation on the EKG was complex, and confirmed COVID-19 cases were complicated by ST-segment elevation, which could have indicated potential acute MI.

Neurologic complications have been reported, with limited case reports from Italy linking COVID-19 infection to Guillain-Barré syndrome. And in China, more than a third of confirmed COVID-19 cases had neurologic symptoms, such as acute cerebrovascular events, impaired consciousness and muscle injury, which were more common among patients who required mechanical ventilation.

What are the long-term sequelae of COVID-19?

It is unclear whether or how often COVID-19 survivors will experience persistent pulmonary or other problems, or for how long. Many patients have remained hospitalized with the illness for weeks outside of China, out of an abundance of caution and for public health reasons.

Researchers from China pointed to cardiovascular system abnormalities in nearly half of a small group of SARS patients in a 12-year follow-up cohort, as well as about two-thirds with high lipids and 60% with glucose metabolism problems. They suggested COVID-19 may also cause chronic damage to the cardiovascular system, as the virus has a similar structure to SARS. Last Updated May 07, 2020.


COVID-19 Info and Advice for All Physicians
COVID-19 presents new challenges for everyone. However, healthcare professionals are facing unique personal and professional challenges within the context of this rapidly shifting landscape.

Individuals may find themselves managing multiple new challenges at once. Some medical professions, such as anesthesiology, emergency medicine, or intensive care, incur greater risks for contamination as they perform intubation procedures on hospitalized COVID-19 patients.

Healthcare clinicians wearing full-body PPE in the hospital are faced with physical barriers to self-care during shifts: eating, drinking, and lavatory visits may be delayed or eliminated, leading to depletion in personal reserves.

Craig Spencer, MD, MPH, director of Global Health in Emergency Medicine and an ER physician at New York-Presbyterian/Columbia University Medical Center in New York City, is on the front lines of managing the COVID-19 patient surge. In a Washington Post op-ed and a Twitter thread, he wrote about his daily experience of navigating the compounding stressors of the patient surge; managing patient life support with limited ventilators; being unable to attend to personal needs during long shifts; and, to protect his family, vigilant decontamination before leaving work and again once he arrives home. Other healthcare clinicians report quarantining themselves in sections of the home to limit the risks of contaminating family members.

These new and daunting circumstances require careful attention to self-care, stress management, and wellness practices to best ensure continued health and performance in a time of great need.


COVID-19 Strategies for Coping and Wellness

1. Take stock. As routines drastically change, health choices may falter. Ask yourself how you are doing in regard to daily health behaviors: the quantity and quality of sleep, exercise, nutrition, and hydration.

2. Stabilize yourself with good health behaviors. After taking stock, choose one area for improvement and set a goal. Examples of concrete goals are maybe 30 minutes of daily exercise, limiting evening screen time in the hours before bed, and eating three servings of vegetables daily.

COVID-19 brings a high degree of uncertainty, and feelings of loss of control are common. Setting a self-care goal can help keep you grounded and focused on things you can control. Good self-care will ensure that your immune system is best supported and able to fight illness. Remember too that when you are well cared for yourself, you can be of best service to others.

3. Observe your stress level. Stress manifests mentally, emotionally, and physically. Observe the tension level in your muscles, the frequency and intensity of any difficult emotions, and potential physical effects such as headaches, upset stomach, or difficulty sleeping.

4. Identify your emotions. Anxiety, sadness, fear, anger, and frustration may all be common. Acknowledge these emotions as they arise. Often, they are temporary and observing them without judgment can allow them to dissipate quicker.

5. Employ stress reduction techniques. Stress activates the sympathetic nervous system and keeps you in a state of “high alert.” Even low-grade prolonged stress can have negative impacts on sleep, mood, blood pressure, cortisol — all of which reduce your tolerance to future stressors. Ongoing stress can also promote unhelpful choices, like using alcohol for stress relief, and further deplete sleep, mood, and energy. In this time of COVID-19, stress mitigation is key, and calming your nervous system is medicinal.

If you have a favorite stress reduction tool, ask yourself if you are using it frequently enough. If you do not have a favorite stress reduction tool, these are some good options to try:

·       Shine: Calm Anxiety & Stress offers a special toolkit for COVID-19 anxiety, with a free app that offers guided relaxation and meditations, daily motivational messages, and an “ask an expert” section

·       Headspace is a stress, meditation, relaxation, and sleep app, free with NPI provider number

·       The UCLA Mindful: Meditations for Well-Being app includes recorded mindfulness meditations of varying lengths and a weekly podcast

·       The Society for Health Psychology, a division of the American Psychological Association, offers a wide range of recommended wellness tools, including a sleep app and resources to address trauma

·       Calm Your Nervous System is a free, stream able, 20-minute guided relaxation audio file. Using headphones or earbuds allows background binaural technology to deepen your relaxation response

Use your favorite tool daily or as needed throughout the day to de-stress, interrupt any unhelpful thought patterns, and as a general wellness practice.

6. Have compassion for yourself and others. Recognize that everyone is doing their best in this time of crisis, including yourself. Remind yourself that everyone is navigating unchartered territory without a playbook. Anchor yourself and avoid reacting to the emotional instability of others. Use any of the calming tools listed above or another you may love.

7. Stay socially connected. Social connection is certainly different with “physical distancing” — and it may be more important than ever. Reach out to others by phone, email, text, or various social media platforms. Check in with older adults, anyone you know to be socially isolated, and daily friends and colleagues that you do not have contact with now due to quarantine or shelter-in-place orders.

8. Find personal space in isolation. Paradoxically, physical distancing is forcing people and families in close proximity for extended periods of time. During a stable time of emotional neutrality, discuss individual needs for personal space and develop a plan.

9. Set a timer and limit your access to the news. Reports of mounting disease and death counts can be distressing and anxiety-provoking. The volatility of the stock market and loss of investment and retirement income may represent a personal threat to security and trigger anxiety or despair. While staying informed is important, limiting news and screen time can support stress management and mental health. If you find yourself constantly scanning the news, consider containing your news-checking to twice daily and for a defined and brief period.

10. Gratitude and positivity. Daily, find a positive story in the news that illustrates resilience and positivity amidst challenge. Allow yourself to reflect on one personal gratitude each day.

Resources and Guidelines by Specialty

Below, the MedPage Today staff has compiled a list of COVID-19 resources for physicians and other healthcare professionals. We will be updating this list frequently to ensure it remains a collection of the latest guidelines, resources, and best practices in dealing with COVID-19 both personally and professionally. You can track the U.S. COVID-19 outbreak on a real time dashboard, by state and by county.

Anesthesiology
American Society of Anesthesiologists library

Cardiology
American College of Cardiology – ACC’s COVID-19 Hub
ASNC/SNMM – Guidance and Best Practices for Nuclear Cardiology Laboratories
European Society of Cardiology – COVID-19 and Cardiology
American Heart Association- COVID-19 Resources
Society for Cardiovascular Angiography and Interventions – Considerations for the Cath Lab Considerations for Cardiac Catheterization Laboratory Procedures During the COVID-19 Pandemic

Dermatology
American Academy of Dermatology

Emergency Medicine
American College of Emergency Physicians
American Academy of Emergency Medicine
American College of Surgeons – How to Set Up a Regional Medical Operations Center to Manage the COVID-19 Pandemic

Endocrinology
American Association of Clinical Endocrinologists – AACE Position Statement: Coronavirus (COVID-19) and People with Diabetes – The American Association of Clinical Endocrinologists’ (AACE) guidance on helping people with diabetes prepare for and prevent the spread of COVID-19. Some precautions for this high-risk population include staying home as much as possible, washing hands regularly, and stocking up on prescriptions. The guidance also advises people with diabetes to check with each individual states’ department of health website to see if he or she is able to purchase an additional 30-day supply of insulin or other diabetes medication.

ENT
American Academy of Otolaryngology-Head and Neck Surgery

Ethics
AMA Journal of Ethics – COVID-19 Ethics Resource Center

Gastroenterology
American Gastroenterological Association
American College of Gastroenterology
SAGES (gastroenterology surgeons)

General
Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic
American Medical Association – Guide to telemedicine
American Medical Association – CMS payment policies and flexibilities

Geriatrics
CDC – COVID-19 Guidance for Older Adults
American Geriatrics Society – information hub and article in Journal of the American Geriatrics Society

Health Policy
CDC – Evaluating and Testing For COVID-19
CDC – Healthcare Infection Control Guidance
CDC – Guidance for Emergency Medical Care Services
CDC – Healthcare Personnel with Potential Exposure Guidance
CDC – Inpatient Obstetric Care Guidance
AMA – COVID-19 Resource Center for Physicians – Includes a physician’s guide to COVID-19 along with information from JAMA and other resources.
AMA – COVID-19 FAQ – Addresses what to tell patients, how to manage PPE, and other practice issues.
National Institutes of Health – Coronavirus (COVID-19)
CDC – Clinician Outreach and Community Activity Call CDC: Contact Tracing Not Needed for HCPs Exposed to COVID-19

Hepatology
American Association for the Study of Liver Diseases

Infectious Disease
Infectious Diseases Society of America
American Society of Microbiology – Novel Coronavirus (COVID-19) resources
The Lancet – COVID-19 Resource Center
New England Journal of Medicine – Coronavirus (COVID-19)

Nephrology
National Kidney Foundation regarding dialysis
American Society of Nephrology regarding dialysis and hospitalized patients with kidney failure

Neurology
American Academy of Neurology- COVID-19 resources
National MS Society – Disease-Modifying Treatment Guidelines for COVID-19 – Recommendations of the National MS Society’s National Medical Advisory Committee
American Headache Society – Headache Clinic Workflows During the COVID-19 Pandemic – Telemedicine and precaution to treat patients
Movement Disorders Society – MDS Statement, References, and Resources for the COVID-19 Pandemic
American Epilepsy Society – COVID-19 Resources for Epilepsy Clinicians – Patient management, medications, and more

Nursing
American Association of Critical-Care Nurses – Resources
American Association of Critical-Care Nurses – Online course on pulmonary, ARDS, and ventilator resources
American Nursing Association
Oncology Nursing Society – Interim Guidance During the COVID-19 Pandemic

OB/GYN
American College for Obstetricians and Gynecologists: COVID-19 Guidelines
CDC – Considerations for Inpatient Obstetric Healthcare Settings
Society for Maternal-Fetal Medicine

Ophthalmology
American Academy of Ophthalmology – Important Coronavirus Updates for Ophthalmologists

Oncology
MedPage Today – COVID-19 Poses Special Challenges to Cancer Care – While having an unprecedented impact on all aspects of the nation’s healthcare system, the COVID-19 pandemic created unique circumstances and challenges for cancer care, according to authors of a review from the early U.S. epicenter in metropolitan Seattle. ASCO – ASCO recommendations
Oncology Nursing Society – COVID-19 Resource Page – Links for providers and patients, Nat’l Comprehensive Cancer Network – COVID-19 Resource Page – Links for providers of cancer care:
American Cancer Society Answers to Common Questions – Oriented toward patients, caregivers

Pathology
College of American Pathologists
American Society of Clinical Pathologists

Pain Management
ASIPP – Statement from ASIPP on COVID-19
American Association of Pain Management – Managing Pain and Related Symptoms during Coronavirus
ASRA – Recommendations on Chronic Pain Practice during the Pandemic
DEA – Coronavirus Guidance

Pediatrics
American Academy of Pediatrics – Management of Infants Born to Mothers with Suspected or Confirmed COVID-19

Primary Care
American Academy of Family Physicians
American College of Physicians

Psychiatry and Psychology
American Psychiatric Association: COVID-19 mental health impacts
Interagency Standing Committee: mental health and psychosocial aspects of COVID-19
The Lancet: The psychological impact of quarantine and how to reduce it
CDC: Mental Health and Coping During COVID-19

Public Health
CDC – Manage Anxiety & Stress

Pulmonology/Critical Care
CHEST
Society for Critical Care Medicine
American Thoracic Society

Radiology
American College of Radiology (ACR) on nuclear-med ventilation scans
ACR on CT scans
Society for Interventional Radiologists

Rheumatology
American College of Rheumatology – COVID-19 Resources
EULAR

Sleep
American Academy of Sleep Medicine – COVID-19: FAQs for Sleep Medicine

Surgery
American College of Surgeons (ACS) general information and directory
ACS: elective case triage
ACS: review committees for triage decision-making
SAGES (gastrointestinal surgeons)
American Association of Neurological Surgeons


 


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MSSNY Thanks Rep. Carolyn Maloney for Leadership on Legislation to Provide Loan Forgiveness to Frontline Medical Professionals


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

MSSNY Thanks Rep. Carolyn Maloney for Leadership on Legislation to Provide Loan Forgiveness to Frontline Medical Professionals

May 6, 2020, Westbury, NY—MSSNY applauds Representative Carolyn Maloney (D- Manhattan) for introducing legislation (H.R. 6720) that would forgive private and federal student loans taken out by physicians, medical residents and a range of other healthcare professionals, caring for COVID-19 patients. The bill also includes researchers working to find a cure and vaccine for the disease. Representative Maloney modeled her proposal after the September 11th Victim Compensation Fund.

“New York physicians have been on the frontlines since the beginning of the COVID-19 crisis, risking their lives to save as many victims of the virus as possible,” said Dr. Art Fougner, President of MSSNY. We’re grateful to Rep. Maloney for her leadership in advancing this important bill, as it’s a critical step in thanking frontline medical professionals for their service during this unprecedented time.  We urge the US Congress to incorporate these ideas into its next stimulus package that is currently under development.

The bill establishes a commission to work with the Education and Treasury Departments to review applications from borrowers and to determine which frontline applicants are eligible for loan forgiveness.

New York State is the hardest hit in the country with 319,000 confirmed cases and 19,415 deaths, to date.

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About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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