Mount Sinai Medical Students Graduate Early, Some To Join a Special Medical Corps

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

Katleen Lozada, MD, one of the first Icahn School of Medicine at Mount Sinai students to sign up for early graduation.

Seventy-seven Icahn School of Medicine at Mount Sinai students earned their medical degrees early on Wednesday, April 15, at a time when Mount Sinai Health System hospitals are experiencing extraordinary and unprecedented demands brought on by the COVID-19 public health crisis. Among them are 19 graduates who matched at Mount Sinai for residency and volunteered to join the Mount Sinai Medical Corps, helping to relieve a strained medical system while answering the call by New York Governor Andrew M. Cuomo for “all hands on deck” to assist in any way.

On that day, a number of the early graduates participated in an informal ceremony—from the safety of their homes and conducted on Zoom—reciting the modern Hippocratic Oath and marking this milestone with faculty, staff, and friends and family, all in virtual attendance. Led by Staci Leisman, MD, FASN, Associate Professor of Medicine (Nephrology), and Medical Education, each graduate made a commitment to “respect the hard-won scientific gains of those physicians in whose steps I walk,” to “respect the privacy of my patients,” to “tread with care in matters of life and death,” and to “prevent disease whenever I can, for prevention is preferable to a cure.”

Staci Leisman, MD, FASN, Associate Professor of Medicine (Nephrology), and Medical Education, led students and faculty in reciting the modern Hippocratic Oath during a virtual ceremony.

The opportunity to graduate from the Icahn School of Medicine a month early—as well as the decision to begin clinical work in the Health System through the Mount Sinai Medical Corps—was strictly voluntary. The Medical Corps is a newly formed training program that gives these newest MDs an opportunity to provide vitally needed support services to an overburdened staff—entering orders, for example, scribing, relaying updates to patient families, and facilitating discharge planning. Also joining Mount Sinai graduates in these efforts are 12 graduates from other medical schools who have matched at Mount Sinai for residency.

“We are extremely proud of the dedication and altruism of our students and their passion for helping our patients and communities at this historic time,” said 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.

Katleen Lozada was one of the first Icahn School of Medicine students to sign up for early graduation. “This is definitely not how I envisioned my graduation, but I just really want to help alleviate the intense pressure on clinical staff working on the front lines. What lies ahead is somewhat unknown, but most of all I am looking forward to helping in whatever capacity is needed,” said Dr. Lozada, who matched in the Emergency Medicine residency. The program has training sites at The Mount Sinai Hospital and Mount Sinai Beth Israel—and at Elmhurst Hospital, which is part of a New York City integrated system of health care facilities that has been particularly hard-hit with COVID-19 cases.

“I would much rather be working and helping during this crisis than sitting at home and watching other able-bodied medical professionals take the brunt of the disaster,” added Dr. Lozada, whose mother is a pediatrician.

Olamide Omidele, MD

Also among the early graduates was Olamide Omidele—now Olamide Omidele, MD—a native of Nigeria who was matched to Mount Sinai as a urology resident. “The health care system is currently strained, and I am hoping that I can provide relief in whatever way is needed,” said Dr. Omidele. “I draw my strength, optimism, and comfort about joining the workforce from my parents, who are the main reason I chose to go into medicine.”

For Dr. Lozada, who is a first-generation New Yorker raised in the Bronx, the opportunity to assist the city she loves was also a motivating factor. “What’s even more exciting is that I’ll have the honor of serving the New York City community I grew up with and am awed by every day,” she said. “I can’t wait to get started!”

Students, faculty, staff, family, and friends participated in the virtual ceremony.

 

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I’m Concerned I May Have Cancer. Can I See A Doctor During the COVID-19 Pandemic?

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

The business world may be on pause due to the COVID-19 pandemic, but that does not mean medical conditions have taken a reprieve. If you are worried that you might have breast or gynecologic cancer, you need expert advice. Elisa R. Port, MD, Director of the Dubin Breast Center and Chief of Breast Surgery for the Mount Sinai Hospital, and Stephanie V. Blank, MD, Director of Gynecologic Oncology for the Mount Sinai Health System and Director of Women’s Health at the Blavatnik Family- Chelsea Medical Center at Mount Sinai, discuss what you need to know about breast and gynecologic cancer and COVID-19.

I have symptoms that make me worried I might have cancer. Should I see a doctor or wait until the pandemic subsides?

Dr. Port: If you feel a lump in your breast, have unexplained weight loss, unusual bleeding or bloating, changes to the color or texture of the skin on the outside of your genitals, or other concerning signs, you should definitely get checked out. Do not delay seeing medical attention due to the pandemic.

Most doctors, including those in the Mount Sinai Health System, are open for business to evaluate potential patients. We encourage patients to reschedule non-essential visits such as routine annual mammograms and check-ins. This helps us keep the office (and waiting room) mostly empty so we can see new or potential patients while maintaining and allowing you to maintain social distancing. When you come into the office, we take you immediately into a private exam room to limit the risk of exposure. We continue to perform imaging tests, biopsies, and other key diagnostic examinations.

If I am diagnosed with breast cancer, will I receive treatment now, or will I need to wait until after COVID-19 has subsided?

Dr. Port: The short answer is: It depends.

It’s important to remember there are dozens of types and subtypes of breast cancer. There are also a variety of treatment options; there’s no one-size-fits-all approach. We can safely delay treatment for some types of very early breast cancers. Others respond to medication that can prevent growth of the cancer until the threat of COVID-19 has decreased and we can more safely proceed with treatment. But the first step is to get an accurate diagnosis.

Fortunately, there are very few emergency situations where you need surgery or treatment within a day or two to prevent a bad or worse outcome. In most cases, we have the luxury of being able to delay treatment without affecting your overall prognosis and survival rate. It is all about balancing the risks and benefits in your individual case.

Some cancers grow very slowly, so we can safely delay care for one to three months. Others may respond to a medication, such as an anti-hormonal drug, that can allow us to hold off on care for a while. If you have a more aggressive type of cancer, we may decide to do surgery or start chemotherapy.

Of course, receiving these treatments in the setting of a pandemic carries certain risks of immunosuppression and we don’t take those risks lightly. Even just coming to the hospital carries some risk. So, we will talk with you about the risks and benefits of each care option and decide together on the most appropriate approach for your individual situation.

Is it safe to have chemotherapy now?

Dr. Blank: Again, there is no blanket answer to this question. You and your doctor need to consider your individual situation. First, it depends on the purpose of chemotherapy. Is it going to cure you? If so, you may not want to interrupt it. If it is controlling your symptoms, that may be a different conversation. You may be able to increase the time between treatments, or there may be another way to help with your symptoms.

At Mount Sinai, we test women for COVID-19 before we start chemotherapy because we know that women who have the virus and are in treatment may get significantly sicker than others. We also take measures to boost patients’ blood counts during this time to help patients fight the disease should they contract it.

Is it safe to have surgery now?

Dr. Blank: Here, too, the answer is not simple. In general, we are trying to delay all the surgeries that we believe can be safely postponed. The reason is that you really don’t want to be in a hospital right now. There are a lot of COVID-19-positive patients there and you may well be exposed to the virus. We look at the risks and benefits and discuss the issues with our patients. We are not delaying the procedures permanently, just until we have a safe environment for our patients so we can perform procedures again. This is not unusual. We often delay surgery when it is safe to do so. Sometimes a patient wants to delay so she can attend a daughter’s wedding or a grandson’s graduation.

Sometimes we can change our treatment approach to avoid or delay surgery. We can change the order of treatment. For instance, if someone was recently diagnosed with ovarian cancer, we may start with chemotherapy instead of surgery. Then we can perform the surgery later, when it is safer. We know that’s safe cancer-wise; we have a lot of data that show this.  Sometimes we can use a different treatment approach. For example, we can treat certain endometrial cancers with hormones. Talk with your cancer doctors; they can tell you what the options are in your individual situation.

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Advice on Distance Learning for Individuals with Hearing Loss

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

According to UNESCO, school closures in response to the COVID-19 pandemic have impacted approximately 1.4 billion students. Children in pre-primary through high school, as well as adults in collegiate and graduate education are now engaged in “distance” or “remote” learning. While this allows education to continue despite school closures, it is not without drawbacks.  Poor audio quality is an impediment for learners at all levels, and can be especially difficult for those with hearing loss. Maura Cosetti, MD, Director of the Ear Institute of New York Eye and Ear Infirmary at Mount Sinai and David Spritzler, MED, Education Specialist at the Ear Institute, share guidance for distant learners with hearing loss.

Guidance for All Distance Learners

As with a classroom setting, individuals with hearing loss have specific needs related to online education. These steps will improve auditory access for all participants in distance learning.

Request that the presenter uses a wearable microphone and is well-lit throughout the lesson.

Using a built-in mic on tablets or computers can produce muffled audio. A wearable microphone doesn’t have to be anything fancy; a Bluetooth headset or the headphones that come free with a phone will significantly improve sound quality.

Additionally, presenters should be well-lit throughout so that students can speech read their mouths.

Ask for a sound check before the lesson and that student microphones are muted throughout the lesson.

A sound check will ensure that the audio is working on both ends. Teachers or presenters can do this by asking each student a different open-ended question, such as, “What’s the last movie you saw?”

Also, having other learners mute their microphones prevents students from talking over each other and introducing distracting background noise to the lesson. Teachers can have students use a signal, such as waving or holding a thumbs up, when they want to speak.

Reduce background noise. 

Turn off music, TV, and loud appliances and be sure to close windows and doors. If your child must share space with other people during lessons, ask everyone to try to be as quiet as possible.

Let the teacher know when you cannot hear.

Adults are likely to know when they are having trouble hearing, and what to do about it.  However, children are often unaware that they are not hearing well and may be shy about speaking up when there is a problem.  Help your child learn to identify problems by encouraging them to ask themselves if they understand what is being said and to let an adult know if they cannot.

Guidance for Children Who Are Distance Learning

Children with hearing loss have additional challenges regarding distance learning. Parents and guardians should adhere to the following tips to ensure that their child has the best experience while distance learning.

Ask for hearing assistive technology from your child’s school.

Ask your child’s school to send home their hearing assistive technology. This equipment, commonly referred to as “FM”, is usually used to improve the signal-to-noise ratio in the classroom, but it can also be used to connect the audio output from a laptop or tablet directly to a child’s hearing aids or cochlear implants, greatly improving sound quality. Some hearing devices can also connect via Bluetooth, ask your child’s audiologist.

Check your child’s hearing equipment.

Make sure your child’s hearing equipment has been freshly charged and that replacement batteries are on hand.

Additionally, do daily “listening checks”: while standing behind your child, ask them to repeat various letter sounds (could try the “Ling” sounds) in random order, then answer open-ended questions.

Request accommodations from the teacher.

Ask that teachers use captioning for videos and that they send presentations and other materials in advance. This will allow you to “pre-teach” new words and familiarize your child with new content.

Also, get in touch with your child’s teacher of the deaf and educational audiologist. They can help troubleshoot problems as they arise and can provide support to you and your child.

Make sure your child takes a break.

Listening through technology is hard work! Give your child plenty of time to rest in between lessons.

Even in the best of times, children with hearing loss have to work harder than their peers to learn, and commonly experience “listening fatigue” from the increased expenditure of energy. Distance learning is proving to be much more challenging than regular school for all students, and the added stresses of not seeing friends or playing outside make it even harder for kids to pay attention and learn. Therefore, it’s not reasonable to expect children to do the same work that they would in normal circumstances. In order to learn, children need to be presented with activities that are challenging, but achievable. Stress is counterproductive. If your child is resistant to doing schoolwork or participating in distance learning, discuss ways to adjust expectations with teachers.

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Mount Sinai’s Antibody Test for COVID-19 Receives Emergency Use Authorization from FDA

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

A renowned team of virologists, pathologists, and clinicians at the Mount Sinai Health System developed, validated, and launched a blood test for COVID-19 antibodies that received the U.S. Food and Drug Administration’s (FDA) emergency use authorization late Wednesday.

The blood test determines whether individuals have antibodies to the SARS-CoV-2 virus that causes COVID-19. It is used for the qualitative detection of human IgG antibodies in serum and plasma that is collected from individuals suspected of having been infected with SARS-CoV-2.

Early development of the assay, led by Florian Krammer, PhD, Professor of Microbiology at the Icahn School of Medicine at Mount Sinai, enabled Mount Sinai to become the first health system in the nation to undertake a convalescent plasma program that transfers the antibody-rich plasma from recovered COVID-19 patients into those who are critically ill.

To date, Mount Sinai has identified more than 1,900 donors who are eligible to provide their antibodies. A total of 141 patients have received the protocol, and the results are being evaluated clinically.

Under the leadership of Peter Palese, PhD, Horace W. Goldsmith Professor and Chair of the Department of Microbiology, Mount Sinai has built one of the world’s leading academic institutions for the study of viruses and emerging pathogens. “The COVID-19 antibody test is not only helpful in identifying individuals who could be donors for the convalescent plasma program but also identifies persons who can safely go back to work now that they are immune to the virus,” Dr. Palese says. This important step would allow the nation to return to economic productivity.

“We are grateful to the FDA for granting this expanded authorization so that we can deploy this vital test to the community at large,” says Carlos Cordon-Cardo, MD, PhD, Irene Heinz Given and John LaPorte Given Professor and Chair of Pathology, Molecular and Cell-Based Medicine. Dr. Cordon-Cardo oversaw the validation of the test that is produced by the Mount Sinai Laboratory, Center for Clinical Laboratories. The Mount Sinai Hospital’s Clinical Laboratories are certified by the Clinical Laboratory Improvement Amendments and accredited by the College of American Pathologists.

According to Dr. Krammer, the antibody test can, in some cases, pick up the body’s response to infection as early as three days post-symptom onset and is highly specific and sensitive. “We have shared the toolkit needed to set up the test with more than 200 research laboratories worldwide to help mitigate this global crisis,” Dr. Krammer says.

David L. Reich, MD, President of The Mount Sinai Hospital, and Judith A. Aberg, MD, Chief of the Division of Infectious Diseases and Immunology in the Department of Medicine, have led Mount Sinai’s convalescent plasma program. “The exchange of ideas between clinicians and scientists and our intense drive to innovate is the catalyst that led to this achievement,” says Dr. Reich. “Mount Sinai will continue to advance the science and medicine in the fight against COVID-19.”

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Should I Prepare a COVID-19 Emergency Care Kit?

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

Everyone is worrying about COVID-19. At home preparation is essential for social distancing and in the unfortunate event that yourself or a loved one becomes ill. Stocking up on the basics is a good approach. But, what do you need to have on hand? Linda V. DeCherrie, MD, Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai, shares what you should have in your COVID-19 Emergency Care Kit.

What types of things should I keep on hand?

In general, you want to have cleaning and hygiene products, a 30-day supply of any medications you may be taking as well as other health care items, and food.

Besides my prescription medication, are there other medicines or medical supplies that I should have on hand?

You might want to stock up on daily multivitamins, vitamin C tablets, and electrolyte replacement drinks, such as sports drinks. Over-the-counter medications are also helpful—including cough, cold, and diarrhea relievers as well as pain and fever relievers like acetaminophen or ibuprofen. If there is a child in the home, be sure to pick up  children’s versions.

If you have special medical supply needs, try to have at least 30 days of supplies such as oxygen supplies, catheters, syringes, as well as blood test monitors and strips. Ensure any medical equipment you use is in good repair. This includes oxygen equipment, nebulizers, CPAP machines, hearing aids, glasses, and assistive technologies.

Also, you might want to have a pulse oximeter—which measures both oxygen levels and heart rate—as well batteries to operate the device. And, if you use a cane, crutch, walker, or wheelchair; check to make sure it is in good shape.

Are there specific cleaning and hygiene products that I should use?

When it comes to basic sanitation and hygiene items, try to have bleach, soap, hand sanitizer, antibacterial wipes, face masks, laundry detergent, and garbage bags on hand. You’ll also want to have some basic first aid supplies at home, like an inexpensive digital thermometer, gloves, and bandages.

Be sure to think about the non-food items you regularly purchase at the pharmacy or grocery store and try to have at least two weeks’ worth on hand. This includes toilet paper, toothpaste, tissues, batteries for hearing aids, and contact lens solution.

What should I have in terms of food?

The best case is to have about 30 days’ worth of food on hand. You’ll want to have nonperishable or canned food in your cabinet or pantry. Basics like rice, beans, and peanut butter are inexpensive and keep well. You might also want to have chicken soup, fresh ginger, onions, lemons, and oregano as well as high-calorie nutrient-rich foods such as avocados, honey, and pectin-rich foods like bananas and apples. If there are people in your family who need special foods—such as infants or people with dietary restrictions—be prepared for their needs as well. For more on how to stock your pantry during COVID-19, read this advice from Mount Sinai nutritionists.

If you have a pet, don’t forget stocking up on food, kitty litter, and pet medications.

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How Older Adults Can Protect Themselves From COVID-19

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

COVID-19 is a concern for everyone. But the elderly may be at increased risk of contracting this virus–or developing a bad case of it. Linda V. DeCherrie, MD, Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai, shares information that the elderly and their caregivers can use during the time of COVID-19.

How can the elderly protect themselves from COVID-19?

The best plan is to avoid contracting the virus. To protect yourself, follow the guidelines from the Centers for Disease Control and Prevention. That means stay home as much as you can. Wear masks and gloves if you must go out in public. Make sure home health aides and any family wash their hands when they come into your home. And, keep in close communication with your doctors and health care team so that you can notify them immediately of any new symptoms.

Should older adults make plans for what to do if they get sick?

It’s always good to think ahead if you can. Now is a good time to talk about the “what ifs” and begin your advance care planning, if you have not done so already. The social workers at your hospital can help. You should also tell your loved ones what your wishes are.  

How can I avoid social isolation and depression?

This is always a concern for people living alone—and even more so now with widespread directives to practice social distancing. Fortunately, we’re in much better shape to address this potential for loneliness now than we were even ten years ago. Use Skype, FaceTime, Zoom, or other video chatting technology as much as you can to connect with loved ones.

It also helps to keep as close to a normal routine as possible. Make your bed every morning and don’t let dirty dishes sit in the sink. Get some exercise, either in your home or by taking a walk, while maintaining social distance. This is also the time to try activities that you don’t usually do: paint a picture, play an old-fashioned board game, piece together a 1000-piece puzzle, read that novel that’s been sitting on the shelf. Equally important, try to limit how much time you spend reading or listening to the news.  

Additionally, you might want to get to know your neighbors and talk with them about emergency planning. If your neighborhood has a website or social media channel, think about joining it for access to people and resources nearby.

While it is true that the available data shows that older adults—and those with serious illnesses—are at somewhat greater risk for severe outcomes if they contract COVID-19; it is important to remember that many older adults will not get the virus. And, among those who do, most will survive. Remember, this will pass. We will get through this together.

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