MSSNY eNews: September 2, 2020 – Siena Poll: 46% of New Yorkers Say Schools Should Remain Closed

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Siena Poll: New Yorkers Still Support Forced Closures
New Yorkers are still solidly in favor of shutting down large parts of society in an attempt to slow the spread of the coronavirus, according to a poll released by the Siena College Research Institute on Wednesday. A total of 70 percent of respondents say state government should prioritize the containment of the coronavirus, “even if it hurts the economy.” Only 23 percent think the state should “restart the economy, even if it increases the risk to public health.” That is basically the same result as when Siena asked the question in early July, when respondents favored public health 70-22.

“Don’t Rush on Schools”

Pollsters also asked about several specific institutions and activities, and by and large, New Yorkers were not in a rush to have them return to normal. On public schools, only 18 percent said that they should reopen for all students immediately, while 33 percent said they should reopen with some sort of a hybrid model. A total of 46 percent said they should stay “closed for now and provide remote instruction as best as teachers can to all students.”

Only 27 percent said that colleges “should bring students back to campus for the fall semester” while 66 percent said their courses should be entirely remote. Respondents were also asked about six different types of activities and whether they “now feel comfortable” participating in them:

· “Visiting a museum” was the only one that anything close to a majority — 45 percent, in this case — say they would be willing to do.

· A total of 38 percent said they are willing to dine indoors, though only 24 percent would be willing to drink at a bar.

· Thirty-one percent said they would be comfortable going bowling and 27 percent are OK going to the gym. And 23 percent would like to go to a movie theater, an activity that Cuomo still has not authorized.

Siena also asked people how their behaviors have changed in recent months. Forty-two percent said they have gained weight, 32 percent lost weight and 22 percent copped to consuming “more alcohol than usual.” (Sept. 2 Politico NY Pro)


NYSDOH Updated Guidelines for Hospital Patients and Nursing Home Residents
The New York State DOH updated its guidelines to require hospital patients and nursing home residents exposed to COVID-19 or influenza to have a coronavirus test. The new regulations also require those individuals to have a coronavirus test if they exhibit symptoms of COVID-19 or influenza. Finally, individuals who exhibit symptoms of COVID-19 prior to death while in the hospital, or on their way to the hospital, but hadn’t taken a COVID-19 test within two weeks before death are required to undergo the coronavirus and influenza tests within 48 hours of death.

Hospitals can use rapid COVID-19 tests that cost $5 to $15 per person when testing a deceased individual. The facilities where individuals with COVID-19 die must report the death to the New York health department after receiving the results of both tests. The state also updated requirements for COVID-19 and influenza testing among funeral directors, coroners and medical examiners that come in contact with individuals who had COVID-19 or were under suspicion of having COVID-19.

A statement from the health department notes that flu season is approaching and said that the department wants to distinguish between COVID-19 and influenza with the increased testing. “In order for New York State to more fully assess and differentiate the number of COVID-19 and influenza-related cases and conduct contact tracing, testing of hospital patients and nursing home residents must be mandatory, where such patients or residents are or were suspected, but not known, to have been suffering from COVID-19 and/or influenza,” the health department states.


Who’s First in Line for a COVID-19 Vaccine?
The first available vaccines against SARS-CoV-2 should be reserved for frontline healthcare workers and first responders, according to draft recommendations from the National Academies of Sciences, Engineering, and Medicine (NASEM) released Tuesday.

Following this “jumpstart phase,” people of any age with comorbidities or underlying conditions that place them at the highest risk of severe outcomes from COVID-19 would be prioritized, along with older adults living in long-term care facilities. These groups combined would comprise about 15% of the entire U.S. population.

NASEM’s 114-page document was released ahead of a public hearing on Wednesday afternoon, and is intended to serve as a framework for policymakers planning fair distribution of what will initially be a limited vaccine supply through Operation Warp Speed — an estimated 10 to 15 million doses, which could cover 3%-5% of the U.S. population.

Phase 2, to be implemented when hundreds of millions of vaccine doses are available, would see vaccination for critical risk workers at high risk for exposure (those in meat processing, grocery store workers, etc.), along with teachers and other school staff, older adults missed during the initial phase, and individuals with underlying conditions at moderately higher risk of poor outcomes. People living in homeless shelters, group homes, prisons, jails, and detention facilities would also be included, as would staff at such facilities. Phase 2 would cover an additional 30%-35% of the total U.S. population.

“In the early phases, prevention of morbidity and mortality, and maintenance of health and emergency services to aid prevention of morbidity and mortality is emphasized more than the reduction in transmission,” the committee stated. “[A]s more courses of vaccines become available, an increasing focus on reducing transmission, starting with high transmission settings, and moving to the general population, would ensure sustainable long-term control of COVID-19.”

Phase 3 would include younger adults, children, and workers in other industries putting them at increased risk of exposure, along with anyone living in the U.S. missed during the previous phases.

NASEM criteria for the “equitable allocation” focused on those at greatest risk of acquiring infection, of severe morbidity or death from infection, and of transmitting infection to others.

Those at high risk of negative societal impact also factored into the equation. “Individuals have higher priority to the extent that societal function and other individuals’ lives and livelihood depend on them directly and would be imperiled if they fell ill,” the committee wrote.

Individuals’ wealth or income was not considered.

While Black, Hispanic, and American Indian and Alaska Native communities have been hit hard by the COVID-19 pandemic, the guidance doesn’t specifically prioritize these populations for earlier vaccination.

“There is currently no evidence that this is biologically mediated, but rather reflects the impact of systemic racism leading to higher rates of comorbidities that increase the severity of COVID-19 infection and the socioeconomic factors that increase likelihood of acquiring the infection,” the committee wrote.

Instead, the framework seeks to target these underlying factors — frontline jobs, crowded living conditions, inability to work from home — that can lead to higher infection rates and

subsequent morbidity and mortality, and relied on CDC’s Social Vulnerability Index to prioritize vulnerable geographic areas within the phases of the draft framework. The draft document was put together at the request of the National Institutes of Health and CDC, and draws on lessons learned from prior mass vaccination campaigns for the 2009 swine flu pandemic and the Ebola epidemic in West Africa in 2013-2016.

“Without transparency regarding the allocation criteria, their ethical rationale, the deliberative process used to formulate them, and fair procedures, it will be difficult to generate and maintain the trust that is indispensable for the public’s cooperation with a mass vaccination program,” the committee stated.

The final report is expected early this fall, and will also address issues of vaccine hesitancy, demand, and promotion, as well as other considerations. (Medpage Sept.2)


Researchers: Coronavirus Antibodies May Last At Least 4 Months After Diagnosis
The AP reports researchers tested more than 30,000 people in Iceland and found “antibodies that people make to fight the new coronavirus last for at least four months after diagnosis and do not fade quickly as some earlier reports suggested.” The findings were published in the New England Journal of Medicine (Sept.1)


Why The ‘6-Foot Rule’ Might Not Stop the Coronavirus
Coronavirus prevention protocols often recommend that people stay six feet away from each other to prevent the virus’ spread, but in a new BMJ analysis suggests those six feet may not always protect you from the pathogen, Ben Guarino reports for the Washington Post.

CDC currently recommends that people say “at least six feet (about two arms’ length) from other people who are not from your household in both indoor and outdoor spaces” to help prevent coronavirus transmission. According to Guarino, the recommendation that six feet of separation can prevent a virus’ spread stems from research conducted by Carl Flügge in the late-1800s, which suggested that a microbe-containing droplet could not travel further than six feet.

However, in later research, scientists found that Flügge’s research did not account for smaller droplets and particles that were invisible to the naked eye and could travel farther than six feet, Guarino reports. And when it comes to the novel coronavirus, experts say a variety of factors—including air circulation, ventilation, and crowd density—could contribute to whether six feet is enough separation to prevent the virus’ spread.

Lydia Bourouiba, an author of the new analysis published in BMJ and a researcher of the fluid dynamics of infectious disease at the Massachusetts Institute of Technology, said, “It becomes very important to not think just about a fixed distance” with the new coronavirus. “It’s very important to think about the air flow,” as well.

For the new analysis, Bourouiba and colleagues reviewed several studies on how far respiratory droplets and areoles that could contain the new coronavirus can spread and how different activities, situations, and mitigation measures could affect those distances. Based on their review, the researchers put together a chart categorizing low-, medium-, and high-risk scenarios for spreading the new coronavirus. The chart, they wrote, “presents a guide to how transmission risk may vary with setting, occupancy level, contact time, and whether face coverings are worn,” and applies “when everyone is asymptomatic”—meaning no one in the scenarios is experiencing symptoms of Covid-19, the disease caused by the coronavirus.

Coronavirus Chart

The researchers explained that, “[i]n the highest risk situations (indoor environments with poor ventilation, high levels of occupancy, prolonged contact time, and no face coverings, such as a crowded bar or night club) physical distancing beyond [six feet] and minimizing occupancy time should be considered.” However, they added, “[l]ess stringent distancing is likely to be adequate in low risk scenarios.”

But the researchers noted a key caveat: The levels of risk represented in the chart “are relative not absolute, especially in relation to thresholds of time and occupancy, and they do not include additional factors such as individuals’ susceptibility to infection, shedding level from an infected person, indoor airflow patterns, and where someone is placed in relation to the infected person.”

According to Bourouiba, the chart can help people “evaluate relative risk in a way that is more subtle than just a one-rule-hammers-it-all.” For instance, she said, “If you’re outside, it’s very well-vented, it’s completely open air, there are no stagnation points in the air flow and people are wearing masks,” you’re in a low-risk setting and likely can be closer to others than six feet with relative safety, Bourouibia said. (Advisory Board, Sept. 2)


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Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.

Rhinebeck Estate for SaleA world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.

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The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.


Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale: 715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building. Windows on Park Avenue and 70th Street. Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent