COVID-19 Update May 21, 2020


Notes from Governor Cuomo’s COVID-19 Briefing

· Hospitalizations are down to 5,187

· Net change in hospitalizations and intubations are down.

· Amount of new hospitalizations: 246

· 105 lives lost yesterday: 78 in hospitals, 27 in nursing homes.

REOPENING: – Rockland County is eligible for elective surgery and ambulatory care.

-NY Coronavirus Hotline: 1-888-364-3065 -Report employers if they are not following proper reopening procedures. – State beaches open tomorrow. – Beaches are limited to 50% capacity. – Social distancing must be followed. – Concessions will remain closed. – No contact sports are allowed. TRACING: – NYS tracers will call infected people. -Caller-ID will read: “NYS Contact Tracing” CHILDREN: – NYSDOH is now investigating 157 cases of COVID-related illness in children. -Today, 13 countries and 25 states and Washington D.C. have reported cases. – Gov reiterated that it is still too early to decide if schools will open in the Fall. -The state will issues guidelines to schools in June. -Schools will submit plans to the state in July. – Summer school will be conducted via distance learning. Q&A: CAMPS:

– Gov: until we have more information on COVID-related illness, it might be a bad idea to send children to camps. REOPENING:

– Reporter said NYC Mayor de Blasio says NYC has to reopen by early to mid- June. – There are metrics that will guide reopening for NYC just like every other region.

Some N.Y. Hospitals Will Allow Visitors as Part of State Pilot
COVID-19 patients will be allowed visitors in some New York hospitals and small Memorial Day ceremonies will be allowed, Gov. Andrew Cuomo said. Sixteen hospitals in New York state will allow visitors as part of a pilot program addressing the heartbreak of COVID-19 patients suffering while isolated from their families and friends.

Cuomo said visits under the two-week pilot program will be time limited. Visitors will need to wear protective equipment and will be subject to temperature and symptom checks. Strict visitation rules were adopted to check the spread of the virus, but they have resulted in painful scenes of patients relying on phones or tablets for emotional conversations with loved ones.

“It is terrible to have someone in the hospital and then that person is isolated, not being able to see their family and friends,” Cuomo said. Nine of the hospitals participating are in New York City, with the rest spread out around the state. Cuomo made the announcement as COVID-19-related hospitalizations and deaths continue to decline. There is an average of 335 new hospitals admissions a day. (Modern Healthcare 5/21)

Strokes May Be Less Frequent, More Deadly Than Previously Thought
Fewer than 1% of hospitalized patients who tested positive for COVID-19 also suffered a stroke, a rate much lower than the 2% to 5% reported in China and Italy, said a news release on a study led by the NYU Grossman School of Medicine.

But the people who had a stroke and the virus were younger, had worse symptoms and were seven times more likely to die, according to the release.

“Our study suggests that stroke is an uncommon yet important complication of coronavirus given that these strokes are more severe when compared with strokes occurring in patients who tested negative for the virus,” says study lead author Dr. Shadi Yaghi, an assistant professor in the Department of Neurology at NYU Langone Health, in the release. Modern Healthcare (5/21)

Mount Sinai Uses AI to Analyze COVID-19 Patients
Mount Sinai researchers have created an algorithm that can detect COVID-19 based on how lungs look in CT scans combined with patient information like age, symptoms, bloodwork, and possible contact with others infected with the coronavirus. “Imaging can help give a rapid and accurate diagnosis—lab tests can take up to two days, and there is the possibility of false negatives—meaning imaging can help isolate patients immediately if needed and manage hospital resources effectively. The high sensitivity of our AI model can provide a ‘second opinion’ to physicians in cases where CT is either negative (in the early course of infection) or shows nonspecific findings, which can be common,” said Zahi Fayad, director of the BioMedical Engineering and Imaging Institute at the Icahn School of Medicine at Mount Sinai. (Modern Healthcare, 5/20)

Brooklyn Clinic to Provide Follow-up Care for Discharged Covid-19 Patients
SUNY Downstate Health Sciences University in East Flatbush has established a dedicated outpatient clinic that is providing ongoing care for discharged Covid-19 patients. The clinic opened May 7 at University Hospital of Brooklyn. Follow-up care is especially important given that nearly 90% of Covid-19 patients treated at SUNY Downstate have had at least two comorbidities, and 30% have had three. The vast majority of patients have been people of color, and many don’t have an established relationship with a primary care physician, said Dr. Mafuzur Rahman, vice chair of medicine at SUNY Downstate. “These patients are dischargeable because they don’t have to be in the hospital, but they’re in no condition to resume normal life,” Rahman said.

There is constantly changing information about how Covid-19 affects different parts of the body beyond the lungs, Rahman said. That has included gastrointestinal symptoms, headaches, stroke like symptoms, heart attacks, nerve damage and multisystem inflammatory syndrome in children.

The clinic plans to follow up with patients on symptoms that may develop once they have left the hospital, Rahman said. And because Covid-19 has no standard of care, the clinic will monitor patients for any serious side effects from medications used to treat the disease while they were in the hospital. SUNY Downstate is in the process of contacting more than 1,000 discharged Covid-19 patients for an initial telehealth appointment. Those who need to come in for an in-person assessment will have priority access to primary and specialty care.

SUNY Downstate has reallocated existing resources to get the clinic up and running, including designating several physicians from each subspecialty—such as pulmonologists and heart and kidney specialists—to provide care as needed. The clinic will care for patients for a month or more following discharge. It will continue operation should there be additional waves of Covid-19 patients, Rahman said. Aside from follow-up care, the clinic will focus on tracking the incidence of post-Covid-19 health impacts over time as well as the success of various therapeutic treatments during recovery, SUNY Downstate said.

The mental health of patients also will be a focus, Rahman said. Rahman and a team of leaders from SUNY Downstate already have been working to help address the mental health needs of frontline health care workers. Dr. Ayman Fanous, chairman of psychiatry, recently told Crain’s that isolating patients from their loved ones has taken an emotional toll on doctors and nurses. The solitude is also affecting patients. Many have been isolated and even intubated for weeks on end, Rahman said. And they may struggle to get back to their everyday activities due to the long-term physical effects of the disease.” (Crain’s 10/20)

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Patients with Obesity May Be At Least Three Times More Likely to Have SevereCOVID-19 Symptoms Than Those with Normal Weight, Studies Indicate

Healio (5/20) reports, “In two cohorts of Chinese adults with COVID-19, those with obesity were at least three times more likely to have a severe case of the disease than those with normal weight, according to two studies published in Diabetes Care.” Furthermore, “increasing obesity was associated with increasing odds of severe COVID-19, and the association between obesity and symptom severity was stronger for men than for women.” In one study, the researchers found “median hospital stay was 23 days for patients with obesity vs. 18 days for those with normal weight.” In a second study, the results indicate “men with obesity were more than five times as likely to develop severe symptoms vs. men with normal weight.”

Speeding in New York City? Yes, Really!
In New York City, cameras captured 296,000 speeders during a five-week stretch beginning in mid-March, an 81% increase from the same period in 2019, according to data collected by the city’s speed-camera vendor. The city says traffic deaths are sharply lower.…Roads in the 10 biggest US metro areas have emptied, with volume down 63% in the New York City region. Meanwhile, cars are going faster during morning and evening rush hours, Inrix found in comparing April 13-17 with the first two weeks of March. (WSJ, May 21)

May 28 Webinar: Leading Causes of Million-Dollar Claims in NYS!
On Thursday, May 28, at 7:30 a.m., MLMIC will host “Million Dollar Claims: A Closer Look,” a complimentary webinar examining major causes of million-dollar claims in New York State. As the State’s leading medical professional liability carrier, MLMIC is well-positioned to provide guidance to medical organizations on reducing the risk of high-exposure claims. These recommendations and strategies are informed by an analysis of factors contributing to $1,000,000 claims over a five-year period.

Presenters Joyce McCormack, a MLMIC risk management consultant and registered professional nurse, and Danielle Mikalajunas Fogel, a medical malpractice litigation expert with Fager Amsler Keller & Schoppmann, will educate participants on:

  • identifying the leading causes of loss in million-dollar claims;
  • analyzing the key factors leading to significant payments in these claims;
  • recognizing the chief medical factors identified in these files; and
  • implementing risk management strategies to lessen the risks of high-exposure professional liability claims within your organization.

Policyholders can sign up for this event via the webinar registration form.

This webinar is designed to offer risk management perspectives to physicians and other healthcare providers, risk managers, quality improvement managers, medical directors, office practice administrators/managers, office practice staff, nurse administrators, patient safety officers and healthcare counsel.

MLMIC is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians and designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

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Veterans Matters: PTSD in Returning Veterans Podcast
Check out MSSNY’s Veterans Matters newest two-part podcast entitled PTSD in Returning Veterans. In Part One, Dr. Frank Dowling, Secretary of MSSNY discusses how to identify PTSD in veterans, leading causes of PTSD and common comorbidities. Click here to listen to Part One.

In Part Two, Dr. Dowling discusses treatment options along with how PTSD affects family members and provides advice to physicians on providing better care for veteran patients with PTSD. Click here to listen to Part Two.

Registration Now Open for Veterans Matters CME Webinar

PTSD in Returning Veterans on June 3, 2020 @ 8:30 am

The Medical Society of the State of New York, along with Cobleskill Regional Hospital are hosting a CME live webinar entitled Veterans Matters: PTSD in Returning Veterans on Wednesday, June 3, 2020.

Click here to register for the webinar

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

· Identify diagnostic criteria for PTSD

· Discuss medical and psychiatric comorbidities of military related PTSD

· Discuss evidence based treatment modalities for PTSD including medications and psychotherapy

· Discuss strategies to help veterans overcome stigma to seek and accept treatment for military related trauma

For more information, contact Jangmu Sherpa at or call (518) 465-8085

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 each of these live activities 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.

COVID-19 Map – Johns Hopkins Coronavirus Resource Center