MSSNY eNews: October 23, 2020 – Non-Medical Vaccine Exemptions Endanger Public Health—Law Must Stand



Although it seems like decades ago, it was just 2019 when NY State was at the epicenter of another infectious disease crisis, an outbreak of measles in Rockland County.  Due to religious and philosophical exemptions, vaccination rates in the county had fallen significantly with data showing six schools with vaccine religious exemption rates above 20% and another 17 schools with rates of more than 8%.

Our MSSNY, along with a large coalition, recognized the perils associated with the falling vaccination rates and worked successfully with the NYS legislature and the Governor to enact legislation eliminating non-medical exemption for vaccinations.  This public health law was signed in June 2019 and will help protect NYS residents against common childhood diseases.

However, a lawsuit (F.F. v. State of New York) was filed by a group of families that previously had religious exemptions from vaccines.   They argued that the new law violates the families’ state and federal constitutional rights to religious freedom. They also asserted that the repeal violates the U.S. Constitution’s Equal Protection Clause and forces them to comply or otherwise violate New York’s compulsory education laws. A trial court heard and dismissed this case, but an appeal has been filed.

Your MSSNY, the New York State American Academy of Pediatrics and the AMA Litigation Center have filed an amicus brief supporting the State of New York in the appeal, saying “eliminating religious objections was clearly in the best interest of public health.”

The brief explains that measles is a highly contagious disease, requiring nearly 95% of the population be vaccinated in order to achieve herd immunity. It goes on to discuss that 3% of the people who receive the vaccination will not be immune and others have medical conditions that prevent them from being safely vaccinated. It explains that, to achieve the goal of herd immunity nearly everyone who does not have a medical contraindication must be vaccinated.

The brief states “New York’s experience has shown that religious exemptions cause vaccination rates to fall below that level, resulting in dangerous and potentially deadly outbreaks. The decision to eliminate these exemptions will protect the health and the lives of New Yorkers.”

Whether we are discussing measles vaccines, flu vaccines or Covid vaccines, scientific knowledge will continue to guide our MSSNY policies and our advocacy as we strive to protect the health and well-being of the residents of NY State.

Bonnie Litvack MD
MSSNY President

MSSNY and Other Physician Organizations Call for NYS DOH and the Governor to Provide Flexibility in Reporting COVID-19 Results
October 22, 2020, Westbury, NY—Today, the Medical Society of the State of New York (MSSNY), the NY Chapter of the American College of Physicians, the New York State Academy of Family Physicians and the NYS American Academy of Pediatrics, Chapters 1, 2 & 3 called upon the NYS Department of Health and the Governor’s office to provide flexibility for reporting results of COVID-19 and Influenza tests performed in physician offices.  A survey conducted by these medical societies found that many physicians will be unable to provide these critically needed tests without more time to report results for fear of the potentially significant penalties for failure to comply.

On September 21, NYS Department of Health Commissioner Howard Zucker sent a notice to all healthcare providers requiring the reporting of all positive and negative COVID-19 and flu tests to the NYS Department of Health within 3 hours.   Additionally, the order requires that the ordering physicians report contact information, employment and/or school information for each patient.  Penalties for non-compliance are up to $2000/day.   The medical organizations are advocating for the removal of the three-hour reporting requirement for the negative tests.

“Physicians across the state share the goal of having information as soon as reasonably possible to begin contact tracing and other containment efforts. Three hours, however, is simply not enough time for busy and overburdened practices to report results, especially negative results,” says Bonnie Litvack, MD, President of MSSNY.

“A survey, conducted by MSSNY in conjunction with several specialty societies, found that over 60% of physicians believe the three-hour reporting period is a daunting, if not impossible, task for many practices,” continues Dr. Litvack.  “Over 78% of the respondents indicated that they are unable to comply with the three-hour requirement.  MSSNY is gravely concerned that these requirements may discourage practices from ordering tests and offering testing at a time when COVID-19 rates are rising in our state and more testing, not less is needed.”

“The reporting requirement is likely to compel many practices to forego providing COVID and flu tests which will inconvenience patients by requiring them to have these tests performed elsewhere,” says NYSAFP president Jason Matuszak, MD. “Also, requiring patients to go to multiple locations for tests increases their risk of exposure. Rapid tests could be done at the primary care practice, as opposed to waiting days to get results back from a commercial lab which would allow patients to know their results sooner.”

“Pediatricians across New York are deeply concerned that the recent three-hour reporting requirement for both COVID-19 and Flu test is unrealistic for community-based practices, says Warren Seigel, MD, FAAP, Chair of NYSAAP, District II.  “The recently imposed requirement will discourage offices from offering Flu and/or COVID-19 tests on site.  Sending patients to alternative venues for testing is inefficient, may contribute to the spread of disease and is a breach of medical home principles.

We urge the Department of Health to work with the house of medicine to design a more reasonable turnaround time so all practices can better serve their patients and still meet the state’s requirements for timely data on infections.”

Urge DOH to Provide More Flexibility on Reporting Results
Join with @MSSNY and urge @GovernorAndrewCuomo and @NYSDOH to
increase the 3-hour reporting window for all COVID and Flu test results so providers can comply!

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Physicians Less Likely to Vote Than Others, 3-State Study Finds
Physicians in California, New York, and Texas are less likely than the general public to vote in elections, according to findings in JAMA Internal Medicine.

Researchers examined data from a national provider registry and voter files from the three states. The proportion of physicians who voted in elections from 2006 through 2018 was significantly lower than the proportion of the general population who voted (average across elections, 37% vs. 51%). This was largely due to lower voter registration among physicians (50% vs. 66%).

Among physicians who were registered to vote, however, voter turnout was higher in all elections relative to the general population (for example, in 2018, 75% vs. 62%).

Findings were consistent regardless of political party.

The researchers conclude, “Future efforts to improve physician voter participation should explore the influence of both increasing voter registration and election turnout.”

JAMA Internal Medicine research letter; Background: Prior Physician’s First Watch coverage of voter turnout among physicians (2016)

Many U.S. Coronavirus Deaths Were Avoidable
If the U.S. death rate had matched that of other wealthy countries, between about 55,000 and 215,000 Americans would still be alive, according to a scathing new analysis by Columbia University’s National Center for Disaster Preparedness.

Why it matters: These countries have taken a significantly different approach to the virus than the U.S., providing yet another example that things did not have to be this way.

  • “Had the U.S. government implemented an ‘averaged’ approach that mirrored these countries … a minimum of 130,000 COVID-19 deaths might have been avoidable given alternate policies, implementation, and leadership,” the authors write.
  • “This discrepancy, which continues to grow daily, provides objective crude measure for assessing the government response to this unprecedented health emergency.”

Between the lines: The analysis points to several factors that set the U.S. response apart from other countries’, including insufficient testing and contact tracing, a delayed initial response, the lack of a national mask mandate or guidance, politicization and the “failure of top officials to model best practices.”

  • “Particularly, it is the inability or unwillingness of U.S. officials to adapt or improve the federal response over the course of the pandemic that has strongly contributed to the nation’s uniquely high COVID-19 fatality rate,” the authors conclude.


NYS NEW Paid Sick Leave Law
Need to know more about New York’s new paid sick leave law effective September 30?  Here is more info from NYS Department of Labor:

AMA Calls for Information Blocking Enforcement Discretion
The Trump Administration’s Final Rule on information blocking requires all physicians to come into compliance with the Rule’s requirements by Nov. 2. While the rule makes several important changes to electronic health record (EHR) vendor technology, including improving usability and interoperability, the rule also creates a new and complex set of administrative and regulatory requirements that physicians must follow in order to be compliant with the information blocking provisions.

Specifically, physicians are required to establish a new compliance framework to handle all medical record requests coming into their office. Information blocking rules require physicians to respond to and release patients’ medical records for nearly every request they receive unless an appropriate exception can be claimed.

Physicians must also examine, create, modify, and update all policies and procedures their organization uses to manage medical record requests. Documenting how a physician applies exceptions—and their organizational policies—to each information request will be important in maintaining compliance with the information blocking rules.

The AMA, along with several professional associations and provider organizations, sent a letter to the Office of the National Coordinator for Health Information Technology (ONC) asking for enforcement discretion for at least one year to allow physicians time to come into compliance with the new rules without fear of being penalized. The COVID-19 pandemic is straining physician resources and office staff and will make coming into compliance with the Nov. 2 deadline impractical. The AMA is also developing a resource to help physicians better understand the rule’s requirements.

Additional fact sheets and webinars on the rule can be found on ONC’s website.

CDC Report: Hispanics’ Death Rates Rose 16.3% in May to 26.4% in August
Hispanic Americans are dying from COVID-19 at higher rates than earlier in the pandemic, a CDC report finds. Researchers analyzed data from 114,411 COVID-19 deaths reported to the National Vital Statistics System and found the percentage of Hispanic decedents rose from 16.3 percent in May to 26.4 percent in August.


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Paid Family Leave Webinars for Employers and HR Professionals: Updates for 2021
The New York State Workers’ Compensation Board is pleased to invite you to a special Paid Family Leave webinar specifically for employers and HR professionals.

Each one-hour, online session will provide an overview of the state’s landmark Paid Family Leave benefit, including important information regarding COVID-19, updates for 2021, and resources to help you share information with your employees.

Paid Family Leave is employee-paid insurance that provides employees with job-protected, paid time off from work to bond with a new child, care for a family member with a serious health condition, or assist when a spouse, domestic partner, child or parent is deployed abroad on active military service.  As of March 2020, Paid Family Leave may also be available in the event an employee, or their minor dependent child, is subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19.


Please join us for a live presentation on one of the following dates. Each session is free, and we will leave time at the end for your questions. Registration is required.

Wednesday, November 4, 2020: 10:00 a.m. – 11:00 a.m.
Wednesday, November 18, 2020: 10:00 a.m. – 11:00 a.m.

Additional Paid Family Leave resources are available

New York State offers complete details on Paid Family Leave at, including updates for 2021 and COVID-19. The employer page also contains helpful resources, including employer forms, fact sheets and past webinars. Help is also available via a toll-free Paid Family Leave Helpline at (844) 337-6303, Monday through Friday, 8:30 a.m. – 4:30 p.m.

Veterans Matters: TBI in Returning Veterans Webinar 
The Medical Society of the State of New York and Nassau County Medical Society are hosting a CME live webinar entitled Veterans Matters: TBI in Returning Veterans on Tuesday, November 3, 2020 at 7:30 am.

Click HERE to view the flyer and register for the program!
When:             November 3, 2020 at 7:30 am
Faculty:           David Podwall, MD

Educational Objectives:

  • Identify signs and symptoms indicative of the spectrum from concussion/mild TBI to severe TBI
  • Examine evidence-based treatment modalities and when to refer to a specialist
  • Identify red flags that indicate alternate or more severe pathology
  • Outline an appropriate management plan for a patient presenting with concussion/TBI including a return to “normal life” protocol

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 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.

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Join Round Table Regarding NYS’s Response to Increase in HIV and Gonorrhea
Dear Colleague,

We invite you to share your ideas and suggestions to inform New York State’s response to the increases in HIV and gonorrhea. This interactive virtual feedback session will provide Monroe County community providers the opportunity to provide input. Insight gained from these sessions will inform New York State Department of Health response to the HIV and gonorrhea increases in Monroe County.

When: Friday, October 30, 2020 | 11am – 12:30pm
Where: Zoom

Please register here. 

Erica Lovrin
Health Program Aide
Office of the Medical Director, AIDS Institute
New York State Department of Health
Room 259, Corning Tower ESP
Albany, NY 12237
518-473-8815 |

CDC Expands Definition Of ‘Close Contacts,’ After Study Suggests COVID-19 Can Be Passed in Brief Interactions
The CDC, on October 21, expanded how it defines a “close contact” of someone with Covid-19 as it released new evidence showing the coronavirus can be passed during relatively brief interactions.

Previously, the CDC described a close contact as someone who spent 15 minutes or more within six feet of someone who was infectious. Now, the agency says it is someone who spent a cumulative 15 minutes or more within six feet of someone who was infectious over 24 hours, even if the time is not consecutive, according to an agency spokesperson.

Close contacts are those who are tracked down during contact tracing and are recommended to quarantine.

The announcement from the CDC comes as scientists described in a new study how a correctional officer in Vermont appears to have contracted the coronavirus during “multiple brief encounters” with six incarcerated people who had COVID-19. The infected people were awaiting the results of their Covid-19 tests while the interactions happened.

In the study, the authors — including officials from the CDC and Vermont’s health and corrections departments — noted that the data for defining a close contact have been limited. “A primary purpose of contact tracing is to identify persons with higher risk exposures and therefore higher probabilities of developing infection, which can guide decisions on quarantining and work restrictions,” they wrote, adding that “public health officials should consider transmission-risk implications of cumulative exposure time within such settings.”

Experts have long noted that the 15-minute, within-six-feet rule was not some sort of threshold that needed to be hit for transmission to occur. So much about whether spread happens depends on how infectious a person is, how well-ventilated the room that people are in is, how the virus might move through the air in a particular setting, whether people are wearing masks, and more. The 15-minute window had just been used as a benchmark to prioritize who should be followed up with for contact tracing and quarantine.

One reason why the length of interactions might matter, experts think, is because people need to be exposed to a certain level of virus if they are going to get infected. Researchers still aren’t sure what that “infectious dose” is — and if a higher dose corresponds to how sick people are likely to get — but the thought is that the longer someone is around someone else who is infectious, the higher level of virus they will be subjected to, and the more likely they are to get COVID-19.

After the officer was diagnosed with Covid-19 in August, health officials and staff at the correctional facility reviewed surveillance footage of his interactions with the six incarcerated people. Though he never spent 15 straight minutes within six feet of any one of them, he was within six feet of them at least 22 times for one eight-hour shift, cumulating in at least 17 minutes of exposure. During their interactions, the incarcerated people were wearing masks most, but not all, of the time, while the officer always had a microfiber cloth mask, gown, and eye protection on.

Garfunkel Wild Names Andrew Blustein Chairman
MSSNY’s Counsel, Garfunkel Wild, P.C., a premier law firm with a specialty in health law, is pleased to announce Andrew Blustein has been named the firm’s new Chairman, effective October 1, 2020. Andrew succeeds Robert Wild, founding member of Garfunkel Wild. While Robert will assume the title of Chairman Emeritus, he is not retiring and will continue his practice and charitable work.

Andrew was appointed Vice Chairman four years ago as part of the firm’s leadership succession plan allowing him to work with outgoing Chairman Robert Wild while transitioning into the new role.

Andrew arrived at Garfunkel Wild 28 years ago and has held multiple leadership positions. He has been a member of the Firm’s Executive Committee for nearly a decade and co-founded and co-chairs the Firm’s Health Care Information and Technology Practice Group and E-Health and Telemedicine Practice Group.

Andrew steps into his new role after another successful year. In the last 12 months alone, the firm doubled the size of its Connecticut office, introducing a new integrated Biotechnology, Life Science and Medical Device Practice group and added 12 attorneys. The firm continues to focus on strategic planning, including attorney development and future growth into new markets and practice areas.

Garfunkel Wild, P.C. is a full-service law firm providing assistance to a broad range of clients, including hospitals, health care systems and other health care facilities, organizations, practitioners, and technology companies. Garfunkel Wild, P.C. is ranked in Chambers USA, The Best Lawyers in America© and Super Lawyers. For more, visit


Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
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 Sale A 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.A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.
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 / or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 /

UES Park Avenue Medical Office Space for Rent – One or Two Days a Week
Elegant office space on UES, in Park Avenue doorman building.  Enormous furnished windowed consult room, large exam room and private secretarial area.  Private elevator to office, huge waiting room and all shared office space. One – two days available; ideal for low volume Practitioner of any specialty. Please contact office manager Theresa – 212-288-2171 or via email at

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Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email

OBGYN Physician for Our Upper East Side Practice
Gynecology office setting only – No Obstetrics. Please contact the office at 212-772-3722 Email: Office Location: VCARE OBGYN 328 East 75th St. Suite 4 New York NY 10021 REQUIREMENTS: Doctor of Medicine degree. New York Medical License. DEA Board Certified OBGYN