Infectious Diseases | Mount Sinai Today

Public Health Students Continue Training during COVID-19 Pandemic

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

Throughout the COVID-19 pandemic, Master of Public Health (MPH) students from the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai have stepped up to the challenge of balancing their training in public health, continuing their in-progress research and outreach work, and taking on new responsibilities in managing the spread of the virus. Students have been involved in COVID-19 clinical care, research and the development of therapies, as well as volunteer work. This includes placing update calls to patients’ families, directing calls to resource hotlines, and coordinating food drop-offs to New York City residents. Showing resilience in the face of an unprecedented situation, students continued to meet the milestones of their professional degree program, and in May, the students celebrated yet another major accomplishment—the presentation of their MPH Culminating Experience project at Public Health Research Day.

More than 50 MPH students presented their graduate-level research at the first-ever virtual meeting of Public Health Research Day on Thursday, May 28. To bring the Mount Sinai community together, the Graduate Program in Public Health kicked off this year’s event with a timely lecture by Jessica Metcalf, PhD, Assistant Professor of Ecology, Evolution and Public Affairs at Princeton University, on the use of serology in monitoring health during the pandemic. Afterward, four students were given the honor of presenting their research in long-form oral presentations to more than 100 attendees on Zoom.

Sofia Bengoa presented work on the East Harlem built environment and its effects on adolescent well-being. Charles Sanky described results of the social determinants of health and patients’ lifetime experiences of discrimination as surveyed within an emergency department. Rui Jiang shared work on leveraging hyperlocal epidemiology to capture missed breast cancer screening opportunities. The last honored speaker was Shivani Rathi, who discussed the effects of early childhood stress, adult resilience, and sexual orientation in Gujarat, India. The afternoon followed with each student’s virtual poster presentation in specialty areas like health care management, epidemiology, global health, health promotion, and other public health fields. The following MPH candidates were recognized for their outstanding poster presentations: Debjyoti Datta, Salvatore Crusco, Erona Ibroci, Kayla Jaeckel, Charles Sanky.

The Graduate Program in Public Health united the student community for a uniquely heartfelt virtual gathering in which three MPH alumni candidly shared their post-graduation experiences. Molly Libou, MPH, Research and Surveillance Manager in the Bureau of Alcohol and Drug Use Prevention, Care and Treatment, NYC Department of Health & Mental Hygiene, walked students through her job search strategies and encouraged students to jump at opportunities to learn and advance in the field. Michael Smith, MPH, HIV Consultant, United Nations World Food Programme, earnestly shared how grueling work projects, like writing and rewriting a master’s thesis, were learning experiences that better prepared him for more significant challenges in his career. Finally, Erica Palladino, MPH, Public Engagement and Strategic Communications Fellow in the Office of the Surgeon General, illustrated the importance of preparing for your future workplace, but also acknowledged that learning will happen on the job as well.

“These are historic times for Public Health,” said Nils Hennig, MD, PhD, MPH, Director of the Graduate Program in Public Health. “We are all reminded how important the role of public health education, practice, and leadership is during this time. I have never been more proud of our students, faculty, and staff than in their response to the COVID-19 pandemic. In our program, I see an unwavering dedication to the public’s health.”

Staying Safe During the COVID-19 Pandemic and Beyond: A Guide for IPV Survivor Well-Being

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

Isolation, uncertainty about tomorrow, and fear of consequences that are out of their control can be common experiences, especially for those in abusive relationships. According to Angela Fernandez, Assistant Director of the Sexual Assault and Violence Intervention (SAVI) Program at Mount Sinai, the voluntary seclusion that many have been practicing in order to prevent the spread of COVID-19 may be compounding these realities for survivors of intimate partner violence.

“Abusers will often isolate a survivor and disconnect them from their support network,” says Ms. Fernandez. “COVID-19 is just another factor that makes these challenges harder for a survivor.”

How can survivors remain safe and connected to support when physical distance is essential for safety? As we weather the current pandemic, Ms. Fernandez provides safety tips for survivors—and their loved ones—that are applicable now and as we enter a new normal due to COVID-19.

Identify a “go to” person or network of people in your physical or digital community.

As much as possible, create scheduled check-ins with your support network, and identify at least two people you can contact with an established code word or phrase that will let them know that you are in trouble. Using this word or phrase will indicate that you need an immediate help or intervention.

Discuss with your support network what “getting help” means to you.

“Getting help” is a catch-all phrase that could mean any number of things. Be sure to let your support network know what should happen immediately after you use a code word/phrase/sentence. Would you like someone to help de-escalate a situation, should someone call 911, or do you need to leave?

“Every survivor’s situation is unique and evolving,” says Ms. Fernandez. She notes that physical violence is often seen as the main threat to a survivor’s safety, despite the prevalence of psychological, emotional, and sexual abuse—which are often concurring and are equally damaging to their well-being. “Using a code word or phrase could very well indicate the immediate need for emotional first-aid as much as a physical intervention.”

Be prepared to leave if your situation escalates.

Think about the easiest and safest routes for you to get out of your home quickly, if necessary. Keep an emergency bag that you can quickly fill (or, pre-packed if safe to do so) with a portion of your medication, money, important documents, and food and that you can access on your own time. Keep your identification on you as much as possible.

Identify the “safest” spaces inside.

To protect yourself during times of escalation, think ahead about what spaces feel safest. This might mean a room where there are no weapons (i.e. avoiding the kitchen) and/or has easy access to a door or window to exit the house or apartment. Identifying the safest areas within the home can at least reduce the risk of harm.

If you are part of a survivor’s support network, remember that the person experiencing intimate partner violence knows their situation best.

What you believe to be best may differ from the survivor’s lived experience. In fact, for a survivor, the risks of leaving can often outweigh the risks of staying—especially during a pandemic that has exacerbated economic instability.

Supporters should be careful not to take control away from survivors, which is what the abuser is doing on a daily basis.

“When we look at the power and control dynamics, just because you think you are taking action with good intentions, doesn’t make it any less disempowering for a survivor,” says Ms. Fernandez. “We should be helping to re-empower that person by making sure they have space to consider what is best for them.”

This is especially important now when there are fewer resources available due to the pandemic but holds true during “normal times,” Ms. Fernandez says. Seeking police intervention should be the exception and not the general practice for supporting survivors of intimate partner violence, she says, but this calculation changes if there is a threat of serious and imminent harm.

If you or a loved one needs advice, assistance, or support regarding sexual assault or intimate partner violence; the Sexual Assault and Violence Intervention (SAVI) Program at Mount Sinai is available to help. For more information, visit the SAVI website or call 212-423-2140.

Additional resources include the National Domestic Violence Hotline and Safe Horizon, which provides social services for survivors throughout the five boroughs.

Learn more about SAVI

People With Down Syndrome May Experience Severe Forms of COVID-19

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

Individuals with Down syndrome, the nation’s most common genetic disorder, represent a small, vulnerable segment of the U.S. population whose comorbid conditions may make them particularly susceptible to severe forms of COVID-19.

In fact, people with Down syndrome who are over the age of 30 appear to be about nine times as likely as the general population to be hospitalized for COVID-19, and their hospital stays tend to be more than twice as long, with a median of 17 days, according to a recent study from the Icahn School of Medicine at Mount Sinai that was uploaded onto the pre-print server medRxiv. Approximately 250,000 people in the United States have Down syndrome.

“When you don’t have a critical mass of people who are able to advocate for themselves, which is the case with Down syndrome, then people start falling through the cracks,” says the study’s senior author, Dusan Bogunovic, PhD, Associate Professor of Microbiology, and Pediatrics, and Director of the Center for Inborn Errors of Immunity, which is part of the Mindich Child Health and Development Institute. “We did not want that to happen. We felt that particular attention should be paid to the prevention and treatment of COVID-19 in individuals with Down syndrome.”

From left: Dusan Bogunovic, PhD, and Louise Malle, MD/PhD candidate

Dr. Bogunovic and MD/PhD candidate Louise Malle led a research team that examined the electronic medical records of 4,615 patients with COVID-19 who were hospitalized within the Mount Sinai Health System. They expected to find one or perhaps even two patients with Down syndrome based on the syndrome’s low prevalence within the population. Instead, they identified six adults, all of whom were in their 50s except for one, who was in her 30s. Two of the six patients, both in their 50s, succumbed to the disease. By comparison, Dr. Bogunovic says, 2 out of 30 cases were fatal in an age, sex, and race-matched control group of people who did not have Down syndrome.

Four of the six Down syndrome patients with COVID-19 were also diagnosed with sepsis, which is a marker of extreme inflammation, according to Ms. Malle. The individuals with Down syndrome were more likely to be hospitalized in an intensive care unit and to have been placed on a ventilator. In addition, she says, a constellation of other health issues associated with Down syndrome, such as autoimmune disease, epilepsy, and dementia, may have played a role in the severity of COVID-19. Further studies will be needed to determine whether these patients were more likely to produce higher levels of inflammatory markers.

Over the past 20 years, improved health care for individuals with Down syndrome has led to increased longevity, with many now living into their early 60s. That however, is still roughly 20 years shorter than individuals without the disorder. The median age of the hospitalized patients with Down syndrome was 54, roughly 12 years younger than the rest of the population that was hospitalized as a result of the disease.

Dr. Bogunovic says one positive finding was that “none of the patients we looked at were pediatric patients, so it does follow the trend of the general population that the older you are the more likely you are to be hospitalized with COVID-19.” He adds that the current study points to the need for “additional research into the medical conditions of marginalized patients with rare genetic conditions,” particularly during a pandemic.

Broadway Performers Honor Mount Sinai Graduates during Virtual Commencement

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

Virtual pomp and circumstance prevailed on Thursday night in a graduation of 62 Mount Sinai residents, and while commencement exercises via Zoom have become the new normal, a special performance by celebrity performers added an element of surprise for the newly minted doctors: an original song written just for them. The ceremony was held by the Department of Medicine at The Mount Sinai Hospital, which is part of the Icahn School of Medicine at Mount Sinai.

An offering of The Clear Day Project, the song, “Keep Your Head Up Child,” was written by actor Joe Tippett and performed by him and his Grammy award-winning collaborator, Sara Bareilles. The song was dedicated to the graduates of the Icahn School of Medicine at Mount Sinai and their instructors who have worked tirelessly and selflessly throughout the pandemic.

“Our Internal Medicine residents were on the front lines of the fight against COVID-19. Their dedication, compassion, and commitment were extraordinary. So I wanted to do something special for these residents who gave so much of themselves during this pandemic. I am thrilled that Sara Bareilles and Joe Tippett wrote this song to honor them and their hard work. I am so very grateful to them for recognizing their sacrifice and for helping us celebrate this important milestone in their medical careers,” says Barbara Murphy, MD, the Murray M. Rosenberg Professor of Medicine, Chair of the Department of Medicine for the Mount Sinai Health System, and Dean for Clinical Integration and Population Health.

The Clear Day Project is a living theatre project co-founded by former Carnegie Mellon drama classmates Jordan Dean, Kersti Bryan, and Dan Amboyer. Mr. Dean had two surgeries, including a 13-hour open-heart surgery, at The Mount Sinai Hospital in 2019. Reacting to the gravity of the pandemic, Clear Day Project assembled an eclectic series of New York performers, including Oscar, Golden Globe, Emmy, Grammy and Tony Award winners, to create artistic messages of gratitude and solidarity for front-line workers at the Mount Sinai Health System titled, “Songs for Mount Sinai”.

“The Clear Day Project was started as a space for New York City artists to bolster those most affected by COVID-19: the front-line workers and their families. We are in awe of the incredible, life-saving work performed by those on the front lines in the Mount Sinai Health System. Their tireless devotion to the people of New York during this once-in-a-lifetime pandemic deserves the highest recognition. We hope the graduates, their families, and staff love Joe and Sara’s performance as much as we do,” says Mr. Dean.

How Mount Sinai Students Have Responded to the COVID-19 Pandemic

Hear More Songs for Mount Sinai

Protecting Yourself from COVID-19 as New York Reopens

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

New York State has been on PAUSE—a period of sheltering in place and the closing of non-essential businesses—since Sunday, March 22, in order to tackle the COVID-19 pandemic. Now that the state has significantly decreased its new cases of the novel coronavirus, Mayor Bill de Blasio and Governor Andrew Cuomo have begun to ease restrictions. While this is a very positive sign of progress, reopening may cause some anxiety for many New Yorkers who have been keeping their distance from others.

Dana S. Mazo, MD, MSc, an Assistant Professor of Medicine (Infectious Disease) at the Icahn School of Medicine at Mount Sinai and physician lead for Infection Prevention at Mount Sinai Queens, explains how to safely transition to a more bustling New York City and what you need to know about protecting yourself as the city and state reopen.

How can New Yorkers prepare for reopening?

It’s completely reasonable to be anxious; we are in unchartered waters. When we stop sheltering at home, life will not go right back to how it used to be—we will enter a new normal. The good point here is that we have been practicing all of the measures we need to take to keep us safe for this ‘new normal’ during the PAUSE. Once we can go outside for more non-essential reasons, we should continue to practice social distancing, wear a mask, clean high-touch surfaces such as door knobs, and practice good hand hygiene. Those are the key behaviors that everyone can do to remain safe.

Additionally, the Mayor and the Governor will reopen the city and state in stages. This will give us time to adapt to the changes so that you can keep yourself, your loved ones, and the people around you safe.

If I am wearing a mask, do I need to continue to practice social distancing?

It is important to keep doing all of the preventative behaviors—including social distancing—regardless of whether you are wearing a mask. The most important role of the mask is to protect the people around you because, even if you are not exhibiting symptoms, you can still be infected with and spread the coronavirus.

The virus is spread via respiratory droplets. So if you are talking, singing, coughing, or shouting without being masked, the droplets can spread from your mouth to someone else. Wearing a mask reduces the spread but doesn’t stop it completely. That’s why wearing a mask alone is not sufficient. You should still practice social distancing—try to keep more than six feet away from other people—and wash your hands.

Hand washing is one of the most important measures that you can do to prevent spreading or contracting the coronavirus. Not only can droplets spread through close, unmasked talking, but droplets can fall on surfaces. If someone touches the surface where infected droplets have fallen and then touches their face, it is possible for them to contract the virus. Additionally, it is very important to stay home if you’re not feeling well, especially if you have a fever, cough, or headache.

While I am excited to get back outside, I am concerned about large, crowded areas. Are there special precautions I should take to protect myself?

The good thing is that your likelihood of becoming infected with the coronavirus outside is less than your likelihood of contracting the virus inside. When you’re outside, there is usually more space so it is easier to social distance likely that you are going to touch the same surfaces as other people. it’s much less likely that you are going to touch the same surfaces as other people, like when you are riding a crowded subway, eating in a restaurant, or going to the movies.

So, being outside is good not just for your peace of mind and enjoyment, but also because it is harder to spread coronavirus. That said, it is still possible to contract coronavirus outside, even if the risk is less than when you are indoors. So, you should still practice social distancing by trying to avoid large groups and to not spend a lot of time around people who you haven’t already been sheltering in place with.

How is Mount Sinai preparing to return to normal operations?

Mount Sinai has been working very hard to make sure that we can safely return to more normal operations. Staff, as well as patients, are required to wear masks while on the premises, and we have made sure that patients can socially distance while in lobbies and waiting rooms.

Additionally, we actively screen both staff and patients for symptoms of the virus.

When patients receive their pre-appointment reminder, they are screened for symptoms and—when they come in for the appointment—their temperature is measured and they are again screened for active symptoms. When appropriate, before high-risk procedures, we will test our patients for COVID-19.

Mount Sinai is also thoroughly cleaning high-touch surfaces like door knobs and elevator buttons—both in the hospital and in the ambulatory clinics—and ensuring there is hand sanitizer easily available throughout our facilities. You will see the dispensers everywhere.

If your reason for coming is COVID-19, we will address that appropriately.

Mount Sinai is working hard to make sure that our patients can safely receive treatment. If you are sick and you need to go see your doctor or visit the emergency room, do not put your health on hold. We want all of our patients get the care that they need.

How Mount Sinai is Keeping Patients Safe

Face Coverings: What You Need to Know

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

Just about everything in our lives has changed due to the COVID-19 pandemic, especially in crowded metropolitan areas like New York. One of the more visible changes is that face coverings have become a part of everyday life. Bernard Camins, MD, MSc, Medical Director for Infection Prevention for the Mount Sinai Health System, offers some basic guidelines on face coverings.

Why should I wear a face covering?
Since early April, the U.S. Centers for Disease Control and Prevention has recommended that people wear cloth face coverings in public settings where other social distancing measure are difficult to maintain, such as when grocery shopping. Shortly afterwards, the governors New York, New Jersey, and Connecticut ordered people to follow the CDC recommendations.

Do I need to use a face mask like the ones I see doctors and nurses wearing?

No. In order to preserve supplies of face masks certified for use by health care workers, the directives require only that you cover your face.

What is the best face covering for me?

Anything that covers your nose and mouth while you are in public is what is recommended in order to prevent the spread of the infection. It can be a handkerchief or a scarf or a bandana. You can make something out of cloth. The CDC has provided plenty of helpful tips. You do not want something that can make you short of breath. There can be shortages of masks for some hospitals and health care institutions, which is why it’s best if you use something other than a medical grade face mask.

What do I need if I am going to Mount Sinai for care?

All staff at Mount Sinai will be wearing medical face masks. If you arrive with a face covering that is not a medical face mask, we will provide you with a medical face mask. If you brought your own medical face mask, you may keep that on during your visit.

Can I reuse my cloth facial covering?

Yes. But you should be aware that the CDC suggests cloth face coverings be washed daily. If you are reusing a facial covering, rather than throwing it away, you should be careful when you take it off, as it may have become contaminated, and you should wash your hands afterwards. Having more than one cloth face covering is recommended.

I have heard a lot about N95 respirators. Do I need one of those?

No. Those masks are specifically designed for health care workers. They must be properly fitted for health care workers in order to guard against breathing in the tiny virus particles that cause the COVID-19 infection while caring for patients who are infected.

Why do I need a face covering?

Wearing a face covering is mostly to prevent you from infecting others by preventing the spread of respiratory droplets that carry the virus when you cough or sneeze. This is important because you may be infected but not know because you do not show any symptoms. Wearing a covering on your face can also provide some protection to you against being infected by others. The COVID-19 disease is transmitted by tiny virus particles in the droplets that come from our mouth or nose when we cough or sneeze. A secondary and less common method of transmission is when these particles land on surfaces people touch, like a checkout counter at the store or a cell phone, and then touch their eyes, nose, or mouth, allowing the virus to spread. We maintain social distance so that if someone should cough or sneeze, these virus particles will fall towards the ground and not come close enough to allow us to breathe them in or to land on our clothing.

Should everyone wear a face covering?
Yes, except for children under the age of 2 or elderly people or others who may have trouble breathing.

I saw face masks advertised online. Is it okay to buy them?

You may be able to buy masks at the store or online. But you should be aware that there are some counterfeit masks on the market.

My glasses are fogging up when I wear a face covering. Any suggestions?

This has been an issue for some people. Some research recommends cleaning your glasses carefully with soapy water and making sure they are dry before putting them on. Fogging can happen as you breathe out and the air goes upward towards your glasses, so you could also try ensuring the covering is tighter above your nose.

Seeing people in the community wearing face coverings makes me uncomfortable. What can I do?

People must change their thinking, their mindset about face coverings and realize that this is just a new part of our lives. It is something we need to become comfortable with in order to prevent the disease from spreading.

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