Infectious Diseases | Mount Sinai Today

New York City Is Reopening. Is it Safe to Date Again?

Updated on Jun 30, 2022 | COVID-19, Sexual Health, Your Health

For much of spring, New York City bars, restaurants, and other public gathering spots remained empty of patrons as New Yorkers adhered to the strict social distancing mandate that helped flatten the curve of COVID-19. But, as the city moves through its phased reopening and people expand their social circle, is it safe to have in-person dates again?

Lina Miyakawa, MD, Assistant Professor, Medicine (Pulmonary, Critical Care, and Sleep Medicine) at the Icahn School of Medicine at Mount Sinai, explains how to seek intimacy while protecting yourself and any partners from COVID-19.

New York City is slowly reopening. As we enter a “new normal” with COVID-19 as a persistent threat, is it safe to re-enter the dating world?

I strongly agree with the recommendations from the U.S. Centers of Disease Control and Prevention (CDC) the World Health Organization to wear masks, socially distance, and practice hand hygiene. While I remain optimistic that our world will thrive again, this pandemic is far from over and another surge is a very real possibility.

If you are thinking about dating, you should consider the risks of any interaction and weigh the risk of possibly infecting yourself or a loved one. These are not easy decisions to make. But we can use this time for self-development as well as to build new skills of communication and intimacy.

Also, it is important to remember that COVID-19 recommendations continue to be updated as we learn more about the disease. Everyone should stay up to date with safety recommendations issued by their state and locality.

If you have decided to have in-person dates, when is it appropriate to have non-masked interactions?

There are currently no guidelines to inform us on how to transition from masked to non-masked interactions. However, it is important to note that mask wearing is based on a risk profile—low, medium, and high. For example, low risk would be walking alone through a secluded section of Prospect Park; medium risk would be strolling along Orchard Beach with a friend; and high risk would be boarding a crowded 7 train. The transition from masked to non-masked interactions should also be based on a risk profile.

To assess your partner’s risk profile, you can ask them these questions:

How many contacts do you have on a daily basis?
Who do you live with?
Do you leave the house? If so, where do you go?
Do you follow the recommendations to mitigate the risk of exposure, like wearing a mask and practicing social distancing?
Do you work in situations with high exposure risk?

Also, don’t forget considering your own risk profile. Do you have an at-risk contact (such as a grandparent or a friend with chronic medical problems) who you see regularly?

Is the virus spread through sex?

Although COVID-19 has been detected in semen and feces, currently we do not think that the virus is spread through the sexual act. But, given that the virus is spread through respiratory droplets—which are much more likely to be shared when in close contact with another person—many sexual acts will be considered high risk. So, as the New York City Department of Health details in its safer sex and COVID-19 fact sheet, minimizing risks by exploring other avenues of meaningful interaction is suggested and recommended.

What should you look for after being intimate with someone new?

After a close, high-risk encounter like sex, you should be mindful of your personal risk of contracting and falling ill to COVID-19 as well as the risk you may pose to those in your own circle. I recommend monitoring yourself closely for any symptoms of COVID-19 (fever, shortness of breath, cough, fatigue, the loss of taste and smell). Also, consider getting a COVID-19 test five to seven days after the interaction. I would also refrain from interacting with any at-risk persons within a 14 day period after the encounter. If you cannot avoid contact with a high-risk individual, take precautions to lower your risk profile by social distancing, choosing to interact with the individual in outdoor spaces as opposed to indoor spaces, and wearing a mask.

What do you tell patients who are frustrated with quarantine and eager to expand their social circle again?

I recognize that it’s not easy to practice social distancing and I acknowledge that human connection and touch is important.

However, just as it is common courtesy to step aside to create space for someone to walk by, you should wear a mask to protect others—as you may be an asymptomatic carrier. And, prior to opening up your circle, you should carefully consider your risk profile and that of your potential partner.

We are all linked in this global fight against COVID-19 and we have to look out for each other to stay safe. The most dangerous illusion you can have during a pandemic is that it’s only happening to other people, someplace else.

What Do I Need to Know About Hotels and Vacation Rentals During the COVID-19 Pandemic?

Updated on Jun 30, 2022 | COVID-19, Your Health

Much as you may be bored with staying home, the decision to travel during this time is a difficult one. Experts recommend avoiding all non-essential travel. Any travel, says the U.S. Centers for Disease Control and Prevention (CDC), increases your chances of getting and spreading COVID-19. But if you still need—or want—to get away, Mirna Mohanraj, MD, a pulmonologist with the Mount Sinai Health System, answers some of your questions about staying in hotels and vacation rentals like Airbnbs during the pandemic.

Is it safe to travel? How should I decide where to go?

The CDC states that travel increases your chances of getting and spreading COVID-19. You should stay home if you have any COVID-19 symptoms, have been diagnosed with COVID-19, are waiting for COVID-19 test results, or were recently exposed to someone with COVID-19.

There’s never been a better time for a staycation. But, if you do want to travel, talk with your doctor about your personal risk and try to avoid areas that are experiencing an increase in new COVID-19 cases. Also, the CDC provides detailed guidelines on personal precautions to reduce your chances of getting and spreading the virus.

Should I stay at a hotel or a rent an apartment?

Both options may increase your risk of getting and spreading COVID-19. Hotels have the added challenge of high-traffic areas like lobbies, elevators, gyms, restaurants, and other common spaces. For this reason, it may be better to stay at a non-shared facility like an Airbnb. Airbnb has posted its safety guidelines to help travelers and hosts know what to expect. For hotels, safety precautions vary. Be sure to inquire about your specific lodging place before arrival.

How do I pick a safe place to stay?

To find a place that meets your comfort level, do your research in advance. Check the hotel or vacation rental website to see if it is following the guidelines issued by the CDC and the U.S. Environmental Protection Agency (EPA). Also, check that the facility is adhering to any state or local guidelines for cleaning and disinfection. In general, the location should follow special protocols between guests as well as throughout the day. They should be especially careful about disinfecting high contact surfaces like doorknobs, light switches, and elevator panels.

It is also important that the location screens staff daily for COVID-19 symptoms as well as follows guidelines for social distancing and wearing masks/appropriate protective gear. Opt for facilities that have committed to reduced occupancy and contactless check-in/check-out and inquire if there is a minimum vacancy period or ‘booking buffer’ between guest departures (Airbnb recommends 72 hours. This may be based on studies published in The New England Journal of Medicine and The Lancet have shown that the virus can live on hard surfaces for up to three days. So, even if a facility does not perform enhanced cleaning perfectly, this should leave adequate time for the virus to die.). Ask if you can text message hotel services rather than communicate in person during your stay. And, check if the facility has contactless room service as your hotel room is the safest place to eat.

Once you arrive, you may find that your hotel experience is different than what you are used to. Some hotels are sealing guest rooms prior to arrival to show that they are following cleaning protocols. Your room may also be stocked differently and may not contain items that are difficult to disinfect, such as robes and blankets. If your hotel/vacation rental is following all the appropriate guidelines, it should be safe to use whatever materials are in the room.

How can I protect myself?

As with everything else during this pandemic, it is best to be prepared. Bring plenty of face coverings and hand sanitizer. You can’t be sure that your hotel or vacation rental will provide these. Avoid face-to-face encounters whenever possible and wear a face covering as soon as you leave your room. Take the stairs instead of the elevator. Try to avoid any common areas, such as gyms, restaurants, and lobbies, and only use your private bathroom. If you find yourself in a common area, be sure to keep six feet away from everyone outside your travel party.

There should be adequate ventilation—even with air conditioning—so, it’s always good to open windows and/or doors for better air circulation. If you’re concerned about disinfection protocol, you can bring your own cleaning supplies. You may even want to personally wipe down high contact surfaces in your room like remote controls, faucet handles, light switches, hangers, and doorknobs.

Is it safe to visit the hotel’s restaurant?

You might want to decide this in advance. Before you leave home, I recommend checking the hotel restaurant website to review its COVID-19 practices including personal protective gear for hosts and servers.

‘Grab and Go’ stations are safer than a sit-down meal and dining in a distanced open-air location is better than indoor service. But, if you do decide to eat in, avoid buffets, self-serve, and valet parking. Also, ask about safety protocols in advance. Is the restaurant limiting occupancy or making an effort to distance diners? Are digital menus available? Can you order and pay via mobile device?

Is the hotel’s pool safe?

Being in a swimming pool or open water is unlikely to increase your risk of contracting COVID-19 as long as you maintain appropriate personal protective habits: frequent and appropriate handwashing after touching high-contact surfaces, face covering outside the water, and social distancing both in and out of the water.

However, before you enter the pool, inquire about the facility’s safety protocols. Is the location using enhanced cleaning and restricting capacity? Also, ask about the cleaning of shared equipment, such as bicycles and beach chairs, between guests.

If you have any other questions, check out the CDC website for full guidelines on travelling during the COVID-19 pandemic.

Testing Early for Viral Load May Lead to Better Care for Patients with COVID-19

Updated on Jun 30, 2022 | COVID-19, Featured, Research

Carlos Cordon-Cardo, MD, PhD

The more SARS-CoV-2 virus, or viral load, individuals have in their bodies, the greater their chances of dying of COVID-19. This association was borne out in a new study at the Icahn School of Medicine at Mount Sinai that was led by Carlos Cordon-Cardo, MD, PhD, the Irene Heinz Given and John LaPorte Given Professor and Chair of the Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Molecular and Cell-Based Medicine.

Dr. Cordon-Cardo and his team measured the viral load of 1,145 patients with COVID-19 who were admitted to the Mount Sinai Health System between March 13 and May 5, during the height of the pandemic in New York. These patients had an overall mortality rate of 29.5 percent. When the researchers adjusted for age, sex, and race, and comorbidities such as asthma, heart disease, hypertension, and chronic obstructive pulmonary disease, they found that a higher viral load was still associated with a significantly higher mortality rate.

Based on such a strong correlation, Dr. Cordon-Cardo and his team would like to see quantitative reporting for viral load added to the polymerase chain reaction (PCR) tests that are used to determine if someone has COVID-19. Right now, PCR tests provide a yes or no answer: either someone has or doesn’t have COVID-19. Determining an individual’s viral load would add another layer of knowledge and could be easily implemented by most testing facilities. PCR tests differ from antibody tests that establish whether someone has recovered and may now have some level of immunity.

The chart demonstrates a significant mortality difference between hospitalized patients with high and low SARS-CoV-2 viral load.

“At the beginning of the disease this is the first test you’re going to get, and more viral presence means a more aggressive disease,” says Dr. Cordon-Cardo. “Chances are you are going to get a lot sicker. Taking Tylenol and staying home is probably not going to be enough to help you.” If doctors are aware of a patient’s viral load, they would be prepared to help the patient remotely or admit them to the hospital for observation and, perhaps, early antiviral treatment. Clinicians would have the opportunity to treat the disease at its earliest stage, the best opportunity to prevent it from becoming more destructive.

The amount of virus individuals have in their body could also determine how much they are able to spread the disease to others. Early quarantining of these “superspreaders” would help protect others. Quantitative testing for viral load is relatively quick and inexpensive, according to Dr. Cordon-Cardo. Results can be obtained in a few hours and easily added to current PCR tests.

Understanding this key differentiator in disease progression is the first step in applying personalized medicine to the standard of care for COVID-19. The study’s first author, Elisabet Pujadas, MD, PhD, a Mount Sinai pathology resident and postdoctoral fellow, says, “Obtaining quantitative results that help guide management for the individual patient is one of the bigger goals here. COVID-19 is unique in that the disease offers many new challenges. People get sick and deteriorate so quickly that it surprises clinicians who are treating them. So it’s hard to know up front who is going to do worse than others.”

Knowing which patient is likely to become sicker would also help hospitals better manage their resources, she says. “This illness is not the same for everyone, and this information has great implications for what the best treatment for each patient may be and how we manage limited resources when there is a big surge of people who need to be cared for.”

Elisabet Pujadas, MD,PhD

Mount Sinai’s Department of Pathology is working closely with the Mount Sinai COVID Informatics Center, which was created in the spring to analyze large amounts of health data among patients with the disease. Together, the groups are developing algorithms based on viral loads, comorbidities, and other clinical values that would help doctors evaluate patients based on individualized data.

“All of this up-front clinical information would help guide us in knowing how infected the patient is, how concerned we should be, and which therapies could help or not so we could do a better job of caring for each patient,” says Dr. Pujadas.

Stratifying patients with COVID-19 would follow the same paradigm of care that has already been established for patients with HIV or cancer who receive personalized medicine.

“The more virus you have, the more virus is going to travel in your blood vessels, like cancer cells. And it happens that certain vessels have receptors to the virus that are hospitable,” says Dr. Cordon-Cardo. “In individuals who already have vascular damage you are now adding another condition and the patient is at much higher risk of getting worse. COVID-19 is different diseases at different moments. We should be able to apply the right treatments and the right management for the patient with the knowledge we are obtaining.”

New Mount Sinai Doctors Among Those Making Valuable Contributions During the Pandemic

Updated on Jun 30, 2022 | COVID-19, Featured

Olamide Omidele, MD, left, a participant in the Mount Sinai Medical Corps, with Mount Sinai residents who mentored him, from left: Julia Blanter, MD; Genevieve Tuveson, MD; Wells Andres, MD; and Kate Kerpen, MD.

In mid-April, as New York’s COVID-19 toll was mounting and medical teams were overwhelmed with patients, 19 fourth-year medical students from Icahn School of Medicine at Mount Sinai heeded the call and volunteered to graduate a month early. Together with 10 other early graduates from Albert Einstein College of Medicine, Rutgers New Jersey Medical School, and Duke University School of Medicine, they joined the Mount Sinai Medical Corps, a newly created training program that would allow them to begin clinical work providing vitally needed support services to overburdened staff at Mount Sinai Health System hospitals. All had been matched to Mount Sinai or other program residencies that would not begin until July 1. Each had cited a resolute need to help during a health emergency.

Initially, most new doctors were deployed in the internal medicine service as part of COVID-19 medical teams. Although they were not directly treating patients or even permitted to enter their rooms, they played a crucial role supporting the medical teams by updating patient charts, putting in orders, requesting physician consults, writing prescriptions, updating patients’ families and, most rewarding of all, coordinating patient discharges. Taking on these responsibilities enabled residents and attending physicians to spend more of their time dealing directly with patients.

“They were ready to go from Day One,” says Daniel I. Steinberg, MD, Professor of Medicine (Hospital Medicine), and Medical Education, at the Icahn School of Medicine at Mount Sinai. “They needed some onboarding, but they had the knowledge and skills and they integrated seamlessly into the hospital. They made a significant contribution and increased our overall efficiency for treating patients.” Dr. Steinberg is also Associate Chair for Education and Residency Program Director for the Department of Medicine at Mount Sinai Beth Israel.

A team of Icahn School of Medicine at Mount Sinai faculty, including David C. Thomas, MD, left, and Salvatore Cilmi, MD, supervised the Mount Sinai Medical Corps participants.

According to David C. Thomas, MD, Professor of Medicine (General Internal Medicine), Medical Education, and Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, the situation was unlike anything that anyone had ever seen and left “even our most experienced doctors wide-eyed.” He says, “These extremely committed medical students chose to drop themselves in at the peak of a pandemic without really knowing what to expect. They had to learn how to work in a hospital and while adjusting to a constantly evolving situation going on around them. They made me proud every day.” Dr. Thomas is also Vice Chair for Education, Department of Medicine, Mount Sinai Health System.

The Medical Corps doctors soon realized that the intensity of the experience—of seeing so many patients suddenly decline or pass away every day, of not having face-to-face patient interaction and not being able to touch them or hold their hand, of watching helplessly as patients were unable to see their families due to visitor restrictions—was extremely stressful. Some wonder if this experience will have long-term effects for them personally. “Most of our classmates processed the situation similarly,” says Katleen Lozada, MD, a new doctor who began her Emergency Medicine residency at Mount Sinai on July 1. “We were lucky to have each other to lean on for support.”

Katleen Lozada, MD, says of the experience: “We were lucky to have each other to lean on for support.”

The new doctors acknowledged the spirit of teamwork that they experienced. “It’s been inspiring to see how everyone has pulled together as a team,” says Olamide Omidele, MD, a Nigeria native who is now a urology resident at Mount Sinai. “Doctors, nurses, people from all different specialties, from senior people to junior people were all coming together with a common purpose. It was an awesome experience to be a part of.”

As the number of COVID-19 cases declined, Medical Corps doctors were redeployed where they were needed most, including presurgical testing, telemedicine triage, and other areas in the inpatient medical service. These responsibilities enabled them, with supervision, to act more in the capacity of residents. They were allowed to enter the rooms of non-COVID-19 patients and do what they were trained to do—to treat patients. “I’m someone who enjoys talking to patients and getting to know them and hearing their stories, beyond just their medical history,” says Yara Sifri, MD, who matched to Mount Sinai’s obstetrics and gynecology residency program and who herself had contracted a mild case of COVID-19 prior to joining the Medical Corps. “That’s what I find the most rewarding about being a doctor.”

Yara Sifri, MD, says the most rewarding part of being a doctor is “talking to patients and getting to know them and hearing their stories, beyond just their medical history.”

Medical Corps members worked approximately 50 hours per week for as many as eight weeks at The Mount Sinai Hospital, Mount Sinai Beth Israel, Mount Sinai Morningside, and Mount Sinai West. They worked under the supervision of a team of Icahn School of Medicine faculty who also oversee residency programs. In addition to Dr. Steinberg, they included John A. Andrilli, MD, Associate Professor of Medicine, and Program Director for the Internal Medicine Residency Program, Mount Sinai West/Mount Sinai Morningside; Alfred P. Burger, MD, Associate Professor, Medicine (Hospital Medicine), and Medical Education, and Associate Residency Program Director, Mount Sinai Beth Israel; Salvatore Cilmi, MD, Associate Professor of Medicine, and Program Director, The Mount Sinai Hospital Residency Program; and Alejandro Prigollini, MD, Assistant Professor of Medicine (General Internal Medicine), and Associate Residency Program Director, Mount Sinai Beth Israel.

“The team of residents and attendings was absolutely instrumental to the success of the program,” says Adriana K. Malone, MD, Associate Professor of Medicine (Hematology and Medical Oncology), Senior Associate Dean for Graduate Medical Education, and Program Director for the Medical Corps program. “In reflecting on the Medical Corps participants, they have had a very positive experience in a novel program—they were able to assist teams in the care of COVID-19 patients at the peak of the pandemic as well as gain confidence in the transition from medical school to internship here.” Their experience was also enhanced with a weekly seminar on COVID-19 topics and weekly debrief sessions.

“We could not be more proud of these young doctors for the courage, devotion, and altruism they have demonstrated, and will continue to demonstrate, throughout their careers,” says David Muller, MD, Dean for Medical Education, and Professor and Marietta and Charles C. Morchand Chair in Medical Education at the Icahn School of Medicine at Mount Sinai. “They are entering clinical medicine at a moment in history that will be remembered for generations as one of the most challenging times our nation has ever faced.”

How Can Parents Safely Get Children Outdoors This Summer?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

As the number of COVID-19 positive cases continue to decrease across New York State, many families are wondering how to resume activities in their children’s lives. We spoke with Catherine Spaulding, MD, a pediatrician at Mount Sinai Urgent Care, to get advice on how parents can safely host playdates, have children attend summer camp, and otherwise get their children outdoors.

Overnight camps have officially been cancelled in New York State for this summer. What precautions should parents take if they are sending children to a day camp?

The New York Health Department has laid out a number of measures for day camps and other child care facilities to follow to ensure children’s safety. These steps include but are not limited to social distancing practices—such as having fewer campers together at a time—staggering drop off and pick up times, limiting non-essential employees and visitors to the camp, and mandating that all employees and campers wear a face mask when they are less than six feet apart. Other mandatory practices include enhanced cleaning and hygiene practices, improved access to hand sanitizer throughout the camp, and encouragement of frequent hand washing during the day.

Camps are also required to screen all employees, vendors, visitors, and children for symptoms or known exposure to a person with confirmed COVID-19 within the past 14 days. However, you can also keep your children and others safe by watching for signs of illness in your child. If you think they are getting sick for any reason, keep them at home, inform the camp, and talk with your doctor about next steps.

For more information about day camps in New York, check out these guidelines from the New York State Office of Children and Family Services.

How can parents safely organize playdates and trips to the playground?

The Centers for Disease Control and Prevention still recommends against playdates with children from other homes. However, if you choose to host a playdate, it is best to keep the group of kids as small as possible. Encourage outdoor playtime and handwashing for at least 20 seconds with soap and water throughout the day, especially after being in a public setting such as a playground. If the playdate involves transportation, try to space the kids as far from one another as possible in the car and drive with the windows down. As in any public space, it is always recommended that any child above the age of two wears a face covering.

Now that larger gatherings are allowed, can children attend birthday parties, cookouts, or other get-togethers?

Large gatherings are safest if they can be held outdoors and if social distancing is respected. A face covering should be worn, and everyone should use hand sanitizer or wash hands frequently throughout the event. If your child has any signs of illness, such as a cough or fever, they should stay home and avoid contact with other children. If you are hosting an event, it may be helpful to talk with other parents beforehand and encourage them to keep their kids at home if they have any symptoms.

Also, it is important to keep in mind that different parts of New York are in different phases of reopening, which changes the number of people allowed at one time. For instance, Phase One allowed ten-person gatherings while in Phase Three allows up to 25 people to gather. Before organizing any event, find out what phase of reopening your region is currently in on the New York Forward site.

If parents are uncomfortable connecting with other families for playdates or get-togethers, what outdoor activities can parents arrange to keep their children active?

Keeping your kids active and promoting time outdoors is really important for their physical and mental health. Outdoor activities such as riding a bike, going for a walk or run, or taking a hike are great ways to keep your children healthy and safe while simultaneously encouraging physical activity. It is best to avoid group activities like basketball or football since these sports require close contact with other kids. However, kicking a soccer ball around is a great option for outdoor play—just remember to wipe the ball clean before and after use.

For more ideas about how to safely engage in outdoor activities, check out this piece from HealthyChildren.org, a website from the American Academy of Pediatricians.

How Mount Sinai is Keeping Patients Safe

Mount Sinai Queens Nurses Share Memories With COVID-19 Patients’ Survivors

Updated on Jun 30, 2022 | COVID-19, Featured, Patient Stories, Stories of Strength

From left: The Rev. Dr. Rachelle Zazzu, Chaplain; Melissa Farmer, RN; Stefanie Dimitriadis, RN; Amparo Sullivan, RN; Jonathan Nover, RN, MBA, Senior Director of Nursing for the Emergency Department; and Francelia Thomas, RN, Nurse Manager.

The nurses of Mount Sinai Queens are giving a precious gift to families of patients who succumbed to COVID-19 during the height of the pandemic—their memories of the patients’ last days.

In one letter, carefully hand-written on lined paper, Amparo Sullivan, RN, reached out to the family of a patient who had “a nice smile behind her oxygen mask” and had spent peaceful moments chatting and holding her hand. “This courageous woman wasn’t just thinking about herself but was deeply concerned about how the pandemic was affecting us,” Ms. Sullivan wrote. “Her bravery and thoughtfulness gave me inspiration.”

Since May, Mount Sinai Queens nurses have been writing such letters to family members, in a program that arose from their determination to console families and their own need to remember the patients they worked so hard to save. The hospital is now returning to normal operations. But in April and early May, Mount Sinai Queens was hard hit by the pandemic; visitors were not allowed at that time, out of an abundance of caution, to help protect patients and staff.

“Our nurses were caring for people as they died, and I was praying for people as they died, and no family was present. And it’s heartbreaking,” says the Rev. Dr. Rachelle Zazzu, MA, DDS, Staff Chaplain for Mount Sinai Queens. “So we have been writing letters to the families, fundamentally saying, ‘Your mother was not just patient No. 1234. We cared for her, and we saw beauty in her, and we want you to know that when she died, she was taken care of with a lot of care.’”

So far about a dozen letters have been written by nurses including Ms. Sullivan, Melissa Farmer, RN, Stefanie Dimitriadis, RN, and Tamara Boncic-Heins, RN. The program began with a suggestion from Ms. Sullivan, says Jonathan Nover, RN, MBA, Senior Director of Nursing for the Emergency Department (ED) at Mount Sinai Queens.

“It was a very emotional time for everyone in the ED. So what Ampy Sullivan envisioned was this: If you are with a patient who is at an end-of-life moment and there is something you would like to share later with the patient’s family, jot down a note with the details and drop it into our Daisy box,” Mr. Nover said, referring to an awards program at the hospital. “Then the goal would be, when things calm down a little bit, to create a procedure for getting those letters to the patients’ families.

From left: Amparo Sullivan RN, Melissa Farmer RN, and Stefanie Dimitriadis RN.

That is indeed what happened. In addition to compiling the notes, Dr. Zazzu and Mr. Nover reached out to nurses for more remembrances during the daily huddles of departments such as the ED and Preoperative, Postoperative, and Palliative Care. Even after many weeks, the nurses had “amazing, vivid memories,” Mr. Nover says.

The nurses were told, “We don’t want this to be a burden, because you have a lot to do,” Dr. Zazzu says. “We are just saying that if writing a letter can help relieve a burden for you, all you have to do is write it, and I will take care of the rest, make sure it gets to the family.”

After receiving the letters, family members have been writing back in profound gratitude. One family called the Mount Sinai Queens nurses “RN angels” and offered to pray for their safety as they cared for patients. The letter-writing program is now well-established at Mount Sinai Queens, Mr. Nover and Dr. Zazzu say. And they hope it can spread through the Health System and beyond, because even though the crisis has waned in New York City, patients can still die without family members, far from home.

“It’s nice that we can tell families about their loved ones, and their stay, and how it affected us,” Ms. Sullivan says. “We hope it will give them a little peace of mind, and it’s therapeutic for us to share these experiences.”

Here are some of the messages from nurses to families, from heart to heart.

“Your mother was in no distress when she passed peacefully. I spoke to her, and told her how much her family loves her.”

“Your father was so, so brave. I won’t forget him.”

“People show you who they are down to the core when they are in life-and-death situations. Your mother was so kind. I prayed for her on my lunch break.”

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