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Mount Sinai Employees Reflect as a Community One Year into the Pandemic

Mar 16, 2021 | Community, COVID-19, Featured

On Thursday, March 11, 2021, Mount Sinai Health System employees marked one year since the World Health Organization declared COVID-19 a pandemic with a day of reflection.

Across Mount Sinai, at 10:30 am, 4:30 pm, and 11:30 pm, employees paused to reflect on everything they have experienced this last year—the loss of loved ones and cherished colleagues, the struggles that have helped them grow, the ways our world has changed, the means by which they find resilience, and the moments and people for whom they are grateful. Sharing this moment together allowed members of the Mount Sinai community to acknowledge where they have been, how they feel today, and how they will move forward together.

Employees at Mount Sinai Queens gathered outside to share the moment together while the Rev. Rachelle Zazzu, DDS, read a blessing and eloquently stated, “One year ago, COVID-19 changed the world. We could suddenly see the top of the tallest mountains, but not our friends and our family. And it changed us forever.”

At Mount Sinai Beth Israel, New York Eye and Ear Infirmary of Mount Sinai, and many of the surrounding ambulatory sites, leaders, chaplains, and wellness committee members rounded on all three shifts over a 24-hour period. They brought LED tea lights and sticky notes to work areas and invited staff to remember and reflect. Many expressed appreciation for the opportunity to participate. Recurrent themes included sadness about loved ones lost to COVID-19, hope about the approaching end of the pandemic, and pride in their “work families.”

The Mount Sinai Hospital, Mount Sinai-Union Square, and other ambulatory locations collected notes of resilience and loss in a central location with tea lights for the community to view and experience collectively. Many sites also shared information on Mount Sinai’s employee wellness resources.

“We had quite a bit of patient participation and a lot of valuable conversations about what people have endured in the past year, whom they have lost, and what they are grateful for,” said Lititia Satpathy, Project Manager, who organized the event at Mount Sinai-Union Square. “Hosting the event in the atrium attracted a lot of attention toward the table, and even if people did not choose to write a note or light a candle, almost everyone acknowledged the meaning behind this important day.”

Like the rest of the world, the Mount Sinai community has experienced immeasurable loss and sacrifice on an individual and community level. And yet, through groundbreaking innovation, an unwavering commitment to our patients, and exceptional agility and teamwork, Mount Sinai employees have saved thousands of lives and have vaccinated tens of thousands of people, bringing us closer as a community and closer to the end of this pandemic.

New Study Uses an Apple Watch to Measure Stress and Resilience of Health Care Workers During the Pandemic

Mar 11, 2021 | Featured

Having a strong social network of family and friends has long been associated with an individual’s happiness and ability to bounce back from life’s setbacks. Now, a team of researchers at the Mount Sinai Health System has used the Apple Watch to capture the effect of such networks on the body, as well, by connecting resilience and support with an individual’s heart rate variability (HRV)—a primary component of the body’s autonomic nervous system (ANS) and a keen indicator of the effect of stress on the body.

Zahi A. Fayad, PhD

In a preliminary study of 361 Mount Sinai health care workers conducted between April and September 2020—a period that included the height of the COVID-19 pandemic in New York City—the researchers identified characteristics that indicate whether a health care worker is prone to worsening stress from the pandemic. They found that individuals with high resilience or emotional support were protected against the effects of stress and had different ANS stress patterns compared with those who had medium or low emotional support or resilience.

The physiological measurements were captured on Apple Watches worn by the participants, who downloaded a customized app. The researchers found that the participants’ physiological results aligned with their self-reported surveys.

“Individuals may tell us about their feelings or symptoms, which is subjective, but HRV is how your body speaks and reveals itself,” says the study’s senior author, Zahi A. Fayad, PhD, Director of the BioMedical Engineering and Imaging Institute, and Professor of Radiology, and Medicine (Cardiology), at the Icahn School of Medicine at Mount Sinai. HRV, which is influenced by the parasympathetic and sympathetic nervous systems, is a measure of the variation in the heart’s beat-to-beat intervals.

According to the study’s corresponding author, Robert P. Hirten, MD, Assistant Professor of Medicine (Gastroenterology), there was a range of emotional support and resilience across health care occupations.

Robert P. Hirten, MD

“One of our goals with this study was to see how the pandemic was affecting the psychological well-being of health care workers and whether we could identify features that would allow us to see which workers would be at risk from these psychological effects over time,” says Dr. Hirten. “If you’re a large health system, you want to make sure your employees have the psychological support they need so they don’t develop long-term effects from the pandemic. Measuring resilience and emotional support may be one way to identify at-risk health care workers.”

The study was initiated at the same time the Mount Sinai Center for Stress, Resilience, and Personal Growth was launched by the Mount Sinai Health System. This comprehensive, first-of-its-kind initiative was designed to help front-line workers manage the ongoing psychosocial effects of the COVID-19 pandemic through workshops, counseling, and wellness apps.

Drs. Fayad and Hirten say that going forward, combining their study with the interventions available through the Center for Stress, Resilience, and Personal Growth will allow Mount Sinai’s most vulnerable health care workers to build resilience and feel they are part of a supportive network.

“COVID-19 disrupted many lives, not only from a health point of view but from routines and social interactions,” says Dr. Fayad. “Many people will recover and that’s resilience. But some other people may not and that’s why we need to offer interventions. That is the power of this technology. It provides us with information you wouldn’t capture in a visit to the doctor or the hospital, but it would be helpful to integrate into our daily life.”

Dr. Hirten says the team’s next steps will be to “study the effects of resilience-building interventions on HRV, the ANS, and on improving the well-being of health care workers.”

In December, Drs. Fayad and Hirten published the results of a separate study among health care workers that showed an Apple Watch detected subtle changes in an individual’s heartbeat that signaled the onset of COVID-19 up to seven days before they were diagnosed with the infection.

These charts below show differences in the nervous system over 24 hours in those with high, medium, and low resilience and emotional support.

COVID-19 Survivors Only Need One Vaccine Dose, New Study Shows

Mar 11, 2021 | Featured

New research from the Icahn School of Medicine at Mount Sinai shows that COVID-19 survivors build strong immune responses after one vaccine dose. In fact, their immune response to the first vaccine dose is equal to—or in some cases even better than—the response to a second vaccine dose in someone who has not had COVID-19.

These significant new findings appear in a study led by Viviana Simon, MD, PhD, and Florian Krammer, PhD, which was published in a letter to the editor in the March 10, 2021, edition of The New England Journal of Medicine.

Viviana Simon, MD, PhD

“We believe that a single dose of the authorized mRNA vaccines (from Pfizer-BioNTech and Moderna) is sufficient for people who have already been infected by SARS-CoV-2,” the virus that causes COVID-19, says Dr. Simon, Professor of Microbiology, and Medicine (Infectious Diseases), at Icahn Mount Sinai. “Our study showed that the antibody response to the first vaccine dose in people with pre-existing immunity is equal to or even exceeds the response in uninfected people after the second dose.”

The study included 110 participants. After their first vaccine dose, COVID-19 survivors who were seropositive at the time of the dose generated antibody levels that were 10 to 45 times higher than their seronegative counterparts who had never been infected by SARS-CoV-2. Equally significant, antibody levels in seronegative individuals rose by a factor of three after their second vaccine dose, while seropositive individuals had no increase in their levels of antibodies after that dose.

Panel A shows the quantitative SARS-CoV-2 spike antibody titers or levels for 110 participants. (These were assessed by means of enzyme-linked immunosorbent assay and expressed as area under the curve [AUC].) Some participants with pre-existing immunity had antibody titers below detection (AUC of 1) at time point before vaccination. Panel B shows the relative frequency of vaccine-associated side effects after the first vaccine dose in 230 participants.

“Our findings suggest that a single dose of vaccine elicits a very rapid response in individuals who have previously tested positive for SARS-CoV-2,” says Dr. Krammer, Mount Sinai Professor in Vaccinology in the Department of Microbiology at Icahn Mount Sinai. “The first dose for these individuals resembles the second (booster) dose in people who have not been infected.”

There were no substantial differences between the Pfizer-BioNTech and Moderna vaccines in the antibody responses they elicited, according to the researchers.

Florian Krammer, PhD

Mount Sinai’s team also observed that in an overlapping group of 230 participants, seropositive individuals experienced more intense—but well tolerated—physical reactions than seronegative individuals following their first doses of the vaccine. Interestingly, the frequency with which they reported fatigue, headaches, fever, chills, and muscle and joint pain after their first dose was similar to the responses among seronegative individuals after their second vaccine dose. Researchers say this is to be expected after the body recognizes the virus—or vaccine—and responds vigorously.

Drs. Simon and Krammer say their findings will require further investigation to determine whether these early differences in immune responses are maintained over a prolonged period of time. If the results hold up, they could influence a change in public policy that would require COVID-19 survivors to have only one dose of the authorized mRNA vaccines. According to Dr. Krammer, several European countries have already updated their policies based on these findings.

“If that approach were to translate into public health policy (that is more widely adopted), it could not only expand limited vaccine supplies, but control the more frequent and pronounced reactions to those vaccines experienced by COVID-19 survivors,” says Dr. Simon.

One Year Later: Icahn School of Medicine at Mount Sinai Says ‘Thank You’ To Residents Who Joined Front-Line Workers During Pandemic Peak

Mar 3, 2021 | Community, Featured

Andres Arredondo, MD

There are many reasons why the Mount Sinai community should be thankful for the residents and fellows who help provide care every day. But their contributions during the height of the pandemic a year ago may be one of the most dramatic, and that was on the minds of many recently as they marked “Thank a Resident Day.”

“As New York City entered its darkest days during the peak of the pandemic, our residents and fellows wanted to jump right in and join their colleagues on the front lines in an act of great professionalism and compassion. They were the backbone that kept us all going during a very difficult time,” says I. Michael Leitman, MD, FACS, Dean for Graduate Medical Education at the Icahn School of Medicine at Mount Sinai. “It makes me proud and very, very happy to know them and work shoulder to shoulder with them,” says Dr. Leitman, a surgeon who specializes in minimally invasive surgical innovations to treat abdominal conditions.

Icahn Mount Sinai runs the nation’s largest and one of the oldest training programs for medical residents. Each year, these programs train approximately 2,500 residents and clinical fellows—doctors in training—in every specialty, including several specialty areas that are highly ranked by Doximity, which polls doctors on the best U.S. training programs. Specialties ranked in the top 20 include Dermatology (No. 4), Physical Medicine/Rehabilitation (No. 9), Nuclear Medicine (No. 12), Otolaryngology (No. 12), Psychiatry (No. 15), OB/GYN (No. 18), and Ophthalmology (No. 20).

Andres Arredondo, MD, is a resident in emergency medicine at The Mount Sinai Hospital who spent time at Elmhurst Hospital in Queens—considered an epicenter of the pandemic in New York City—when the pandemic struck last spring. Originally from Colombia, he was struck by the disproportionate effect of the pandemic on the Hispanic community.

Ciera Sears, MD

“The impact of the pandemic on the Hispanic community really highlighted the need for us to place an emphasis on addressing the social determinants of health, such as economic stability, crowded living conditions, quality education, and access to health care,” he says. “We worked long, hard hours but we banded together and supported each other. I was impressed by my fellow residents. Some voluntarily worked extra shifts, some started fundraisers for the Queen’s community, while others helped out in departments that were stretched. We all pushed ourselves to give as much as we could. I’m thankful for all of these things.”

Ciera Sears, MD, a fellow in Geriatrics and Palliative Medicine, was one of many fellows and residents called upon during the pandemic to embed in the hospital’s emergency department, where she would provide counsel to patients at risk of dying, all the while giving much appreciated support to her busy colleagues in the ED.

“We were seeing patients in the worst days, close to death, and alone. Because it was too risky to allow family to enter the hospital, their only support was their doctors and nurses,” says Dr. Sears. Dr. Sears was infected with COVID-19 during the first week New York State was in lockdown. She lost her sense of smell for six months but is now feeling well.

At the same time, the Black Lives Matter movement was gaining momentum, and Dr. Sears was on the front lines. “Here I was risking my life to fight this pandemic which disproportionately affects Blacks and Hispanics, and simultaneously engaging in protests,” she says.

Click here to watch a special video thanking Mount Sinai residents and fellows from Scott Gottlieb, MD, the FDA commissioner from 2017 to 2019, who graduated from Mount Sinai School of Medicine and was a resident in Mount Sinai’s Internal Medicine Residency Program. Dr. Gottlieb is a member of the Mount Sinai Board of Trustees.

Caitlyn Kuwata, MD

Caitlyn Kuwata, MD, also a fellow in Geriatrics and Palliative Medicine, was deployed to the ED where she used her training in palliative medicine to support patients and their families with difficult decisions and symptom management, sometimes with patients who had very little time left.

“Because the COVID numbers were so high, we did a lot of emergency consults on big issues like patient values and goals surrounding quality of life in the context of COVID. It was very eye opening and emotional. One of the hardest aspects of our work was assisting our patients in saying goodbye to family members who were not allowed to visit,” she says.

She became infected with COVID-19 in March. “The two week quarantine while sick was really hard. I wanted to work and I wanted to be useful,” she says.

“Like all of our wonderful staff, my fellows were rock stars during the pandemic and beyond,” says Helen Fernandez, MD, MPH, Professor and Program Director for Geriatrics and Palliative Care at Icahn Mount Sinai, the top rated Department of Geriatrics in the United States according to U.S. News & World Report. “They were true advocates for patients and caregivers, helping them navigate complex decision making. I consider myself extremely lucky to work with such gifted and talented staff. Our future is bright.”

Thank a Resident Day, created in 2018, was marked on February 26. It is one of a number of programs run by the Arnold P. Gold Foundation to champion humanism in health care. The foundation also established the White Coat Ceremony in 1993 as a way to welcome first year medical students.

Artificial Intelligence Tools May Detect Abnormalities that Could Otherwise Be Missed

Updated on Nov 19, 2025 | Artificial Intelligence, Featured, Research

Mount Sinai radiologists are comparing machine-read patient discharge summaries with original, human-read reports.

A patient’s electronic health record typically contains a trove of information that can be used to help predict and manage their future health needs. But much of that information is often composed of unstructured or fragmented data that first must be translated into language that physicians are able to understand.

A new partnership between the Mount Sinai Health System’s Department of Radiology and an Israel-based start-up, Maverick Medical AI, is exploring how to accomplish that task through the use of artificial intelligence. In a proof-of-concept study, Maverick’s deep learning and natural language processing (NLP) algorithms are being used to accurately identify co-morbidities in 1.5 million patient discharge summaries and radiology reports. If it is successful, Maverick’s program could open the door for its use in an array of medical, research, and business opportunities at Mount Sinai.

David Mendelson, MD

David Mendelson, MD, Vice Chair of Radiology Information Technology at the Icahn School of Medicine at Mount Sinai, is playing a key role in the research. He says one of Maverick’s strengths is its ability to report on secondary abnormalities in nearby organ systems that are sometimes only partially seen or could possibly be overlooked in radiological screenings.

“If someone is screened for lung cancer and the findings are negative, that’s great news for the patient,” says Dr. Mendelson. “But if natural language processing could identify secondary indications like coronary artery calcification or abnormal density of the liver, which might suggest non-alcoholic fatty liver disease, that information could prove very useful to physicians and patients. Physicians might be able to take preventive steps to improve outcomes for patients and ultimately lower health care costs downstream.”

Determining whether Maverick’s propriety algorithm can provide that important information is the responsibility of Pamela Argiriadi, MD, Assistant Professor of Diagnostic, Molecular and Interventional Radiology at Mount Sinai. Dr. Argiriadi and a team of residents are spot-checking secondary co-morbidities extracted by the algorithm from an ocean of radiology reports and discharge summaries to determine how they compare to the original, human-read reports.

“Radiology reports contain a wealth of information and we hope our study will shed light on how key-word phrases in those documents can be mined to provide input into the well-being of patients,” Dr. Argiriadi says. “A major goal of ours is to improve communication with primary care providers by reporting secondary findings to them, which can result in follow-up treatment and preventive medicine.” The software can recognize these findings within the report, extract them, and flag them for the provider.

Yossi Shahak, Co-founder and Chief Executive Officer of Maverick Medical AI, estimates that as much as 80 percent of a patient’s health information remains untapped due to its unstructured format. Translating that raw, fragmented data into medical coding language would provide physicians with actionable clinical insights.

“We are starting with radiology and hope to expand the vocabularies across many medical subspecialties, like cardiology and gastroenterology,” says Mr. Shahak. “That expansion of our data sets could provide Mount Sinai physicians with significant value when they mine it for often overlooked chronic conditions and risk factors. In addition, the conversion from unstructured data into medical coding will help Mount Sinai improve their financial capabilities.”

Should You Get the COVID-19 Vaccine If You Are Pregnant?

Updated on Jun 30, 2022 | BFWHRI, COVID-19, Featured, OB/GYN, Vaccines, Women's Health

If you’re pregnant, you likely have a lot of questions about whether it’s safe for you and your baby to receive a vaccine against COVID-19. In this Q&A, Jill Berkin, MD, Assistant Professor of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai, draws on her vast experience as a high-risk obstetrician—as well as her own pregnancy—to offer her perspectives on side effects, vaccines and breastfeeding, and how to decide if vaccination feels right for you.

“Pregnant women should weigh their personal risks of coronavirus exposure against their tolerance of the unknown regarding vaccination,” says Dr. Berkin, who received two COVID-19 vaccine shots during her second trimester of pregnancy. “Right now our information is limited, but all the information we do have suggests that COVID-19 vaccines are safe in pregnancy.” She suggests those with specific questions about their own situation consult with their health care providers.

Why did you get the COVID-19 vaccine?

As a high-risk obstetrician I saw firsthand how pregnant women were affected by COVID-19. I also thought about my day-to-day exposure to the coronavirus through my work. I was more concerned about the known risks of infection than the unknown risks of vaccination, so my decision was easy.

Jill Berkin, MD

In general, do you think other pregnant women should get the vaccine and why?

It’s really important for pregnant women to realize that we don’t have data saying the vaccine is unsafe during pregnancy. Even though our data are limited, all of it points to the fact that vaccination is safe, and we don’t see any side effects specifically impacting the pregnancy itself. We haven’t seen any harm among women who were pregnant after receiving the vaccine in clinical trials.

In addition, each individual pregnant woman has to evaluate her own potential risk for exposure just like I did for myself. As a health care worker my exposures were great, so they outweighed any fears of the unknown with the vaccine. And of course, people who are pregnant may want to consult their own physicians for advice as well.

What are the risks and complications of COVID-19 and pregnancy?

Most pregnant women infected with the coronavirus will have symptoms similar to those who are not pregnant. The vast majority of pregnant women affected are asymptomatic. A large portion of the population has symptoms similar to a cold or flu, including muscle aches and fever. Then there’s a small portion of the population that has more severe disease that might require hospitalization. The data we have now comparing pregnant individuals to non-pregnant individuals shows that symptomatic pregnant women do have a slightly higher risk of a hospital admission, ICU admission, and even mechanical ventilation, but there’s no increased risk of mortality.

Would you say then that pregnant women are at higher risk of developing severe COVID-19?

While it’s hard to fully analyze, the data suggests that pregnant women are at increased risk for developing severe complications of COVID-19. But we have to remind ourselves that in general, pregnant women who become ill are more likely to present to their physicians than women of the same age who are not pregnant, and that’s because you see a doctor more often when you’re expecting. Doctors will also be biased towards admitting women who are pregnant and keeping a closer eye on them because there are two patients at stake.

For those getting the COVID-19 vaccine, what are some side effects to be expected?

The most common side effect that people report is soreness in the arm, similar to a lot of other vaccines. Afterwards some patients might experience mild cold- or flu-like symptoms for about 24 hours. This seems to happen more frequently with the second dose, which is three or four weeks after the first dose. Pregnant women, along with the rest of the population, can take pain relievers such as Tylenol after their vaccine shots to help alleviate some of those symptoms.

Do you think there’s an optimal time for receiving the vaccine during pregnancy?

We don’t have any research to suggest that there is an unsafe time to vaccinate during pregnancy. However, pregnant women might consider not receiving the vaccine during the first trimester. This is only because in general we avoid medical interventions in the first trimester, which is the period of “organogenesis” when the baby’s organs are forming. We don’t have data suggesting there are any negative effects of the vaccine on organ systems. But because we are dealing with a lack of information regarding COVID-19 vaccines and pregnancy—and out of an abundance of caution—perhaps delaying vaccination until the second or third trimester, if possible, could be beneficial.

What do you recommend about vaccination during breastfeeding?

The vaccine certainly has no risks, and only potential benefits. We know that one of the most wonderful things about breastfeeding is that women pass antibodies through their breast milk to their babies. We don’t have much information specifically about antibodies created from COVID-19 vaccination being passed through breast milk. But we do have encouraging data about women who were infected with coronavirus itself forming antibodies and passing those antibodies along through the placenta and through breast milk. So the benefit of being able to protect children against coronavirus when a vaccine is not currently available to children is a remarkable thing and a unique advantage of being a lactating mom.

Luciana Vieira, MD, who conducted the Q&A, is an assistant Clinical Prof of OB/Gyn and Reproductive Science at ISMMS and the Blavatnik Family Women’s Health Research Institute Scholar for 2020-2021. Dr. Vieira has been integral in creating a perinatal database to collect/analyze data on maternal + neonatal outcomes within Mount Sinai Health to improve care.

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