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Rich Sternberg

STERNBERG: Navigating Without a Compass
LIFE IN THE TIME OF COVID-19

Navigating Without a Compass

Richard Sternberg, a retired Bassett Hospital orthopedic surgeon, has agreed to provide his professional perspective while the coronavirus threat continues. Dr. Sternberg, who is also a village trustee, resides in Cooperstown.

One thing is very clear when dealing with a pandemic, it is very important to have good statistics in order to determine a plan of attack. Without good numbers it’s hard to say what to do next. It’s also important to understand what these numbers mean.

With COVID- 19, it has proven difficult to determine its morbidity and mortality rate and its infectivity. Additionally, we’re not sure exactly what the tests that are being done mean. There’s a great deal of controversy about accuracy, especially about the antibody test which shows people who have the disease.

Some people die of the disease. Many of these people have pre-existing conditions. This is obviously common in elderly people. Some people have absolutely no pre-existing conditions and are dying of COVID-19 solely. Many people who contract the infection will survive it but may have long-term health consequences.

We have no idea what this percentage will turn out to be. Some people contract the virus that are totally asymptomatic. They have no illness at all. Unfortunately, they are probably still contagious and can infect others who become symptomatic.

When we have good numbers of the size of a population, the number of people affected, number of people who die, and the number of people who develop permanent medical problems, we can start to develop good plans.

Unfortunately, we now recognize that we don’t have a good handle on these basic statistics.
We were able to determine what percentage of those who were tested and confirmed with COVID-19 died. The problem with that is many people who died during this period went unrecognized as having
COVID-19 because the algorithm to decide who would be screened did not recognize that most infected people wouldn’t have classic symptoms. This makes the statistic of the percentage who died unreliable.

In Italy, it initially looked like 10 percent of the victims were dying. In Germany, it looks like less than 1 percent of the victims are dying. In the United States it looks like at least 5 percent die.

To figure out the real infection, fatality and morbidity rates, we are going to have to know the size of the population, what percentage of the population actually contracted the disease, and what percentage was symptom-free.

A study in New York City, which Governor Cuomo frequently refers to, shows that approximately 20 percent of the population have antibodies to COVID-19, which indicates that they were infected and implies that they have some level of immunity even if only temporary.

The official numbers of New York City are approximately 204,000 cases and 16,400 deaths. This represents a fatality rate of approximately 8 percent. But there seems to be a number of patients “missing”: 20 percent of 8 million is 2 million. Where are the missing 1.8 million cases?

If we take the number of deaths and divide that by the total number of cases, assuming those numbers are close to accurate, we get 16,400 divided by 2 million. Which is only 0.8 percent. This has to be adjusted for the deaths that haven’t been officially determined.

It appears that the disease is more prevalent and a lower mortality rate than initially thought. It also appears that as much as 90 percent of the population infected are not diagnosed.

A retrospective research paper that I read from a specialty hospital in New York City showed that otherwise healthy patients that were scheduled for surgery in April 2020 and did not warrant testing had an infection rate of approximately 12 percent, of which 58 percent remained asymptomatic even with the stress of surgery.

Whether it is determined by statistical methods or by formal scientific studies it is clear that a very significant percentage of patients with COVID-19 never show symptoms.

In summary, it’s clear that we do not have very good statistics which makes it more difficult to make informed decisions.

Hopefully, the statistics will improve. But the important point to take away from this is, regardless of the percentage who have the disease, a large number of people are dying from it.

Even if the fatality rate is only 0.5 percent, if we don’t get a vaccine, we can expect 70 to 80 percent of the population to contract the disease, which in the United States would be more than 200 million people and therefore 1 million people will die.

Let’s hope we can keep the curve flat until a vaccine is found.

Cooperstown To Allow Outdoor Vending June-Oct.

Cooperstown To Allow

Outdoor Sales For Summer

By LIBBY CUDMORE • Special to www.AllOTESGO.com

Mayor Tillapaugh

COOPERSTOWN – In an effort to help businesses and bring shoppers back downtown, the Cooperstown Village Board has declared June 1 through Oct. 12 as a Special Event, dubbed “Cooperstown Outdoors,” during their meeting this evening.

Business owners in the Commercial District – Main Street – will be allowed to apply for a permit to hold sidewalk sales.

“By establishing a special event, we can allow for vending in certain locations,” said Cindy Falk, Village Trustee. “A lot of our shops are in smaller spaces, so it may be advantageous to them to be able to sell on the sidewalk.”

Suffer The Poor Children

Life In The Time of COVID-19

Suffer The Poor Children

Richard Sternberg, a retired Bassett Hospital orthopedic surgeon, has agreed to provide his professional perspective while the coronavirus threat continues. Dr. Sternberg, who is also a village trustee, resides in Cooperstown.

There remains a lot about SARS-CoV-2 and COVID-19 that we don’t know. What was “common knowledge” yesterday could be proved wrong tomorrow. The risk of morbidity and mortality in children was one of the things we thought we knew but now appears that we didn’t.

SARS-CoV-2, the currently accepted scientific name for the coronavirus that causes COVID-19, appears to be the precipitating cause of a newly recognized syndrome that causes destruction of multiple organ systems in children.

This syndrome is so recently recognized it is still referred to by many names, Pediatric Multisystem Inflammatory Syndrome, P-MIS (how the state Department of Health has been referring to it up to now), Multisystem Inflammatory Syndrome in Children, MISC (Center for Disease Control designation since this weekend), Kawasaki Disease-like syndrome, and Toxic Shock-like Syndrome. For all I know by the time you read this there will be an agreement on one of these or something totally different.

MISC was recognized only a few weeks ago. May 5 an article in the New York Times talked about a mysterious ailment in children possibly related to COVID-19. At that time, it was recognized in 15 hospitalized children with no deaths. As of Sunday May 17, there were 137 recognized cases with three deaths in New York. Other countries and regions having been alerted to this phenomenon are now reporting this.

At first children presenting with symptoms of this were misdiagnosed. They had none of the hallmark symptoms of COVID-19, i.e. viral pneumonia and other respiratory symptoms. They appeared to have Toxic Shock Syndrome or Kawasaki Disease but no reason for developing that was found. They hadn’t been recently ill.

Nevertheless a few specialty physicians in children’s hospitals thought to test these children for SARS-CoV-2 and some tests came back positive. Later in the approximately first hundred children recognized with MISC in New York, 40 percent had a positive test for SARS-CoV-2 and 60 percent had a positive antibody test which as most of us are aware of means it was highly probable that they had the disease even if there weren’t respiratory symptoms.

While so far there appears to be only a 2-3 percent risk of fatality in children with MISC we do know that there is damage to critical organ systems in the body: heart, lungs, vascular, kidneys, liver, etc. There is a very good argument that this may lead to permanent impairment of these organs such as in the case of many other infectious diseases in children in which initial symptoms appear to fully resolved. For example, scarlet fever, rheumatic fever, Lyme disease, and viral cardiomyopathy.

While there only appears to be a relatively small number of these cases so far (small statistically but what solace is that to a parent whose child develops this) it is totally unclear what long-term health consequences may occur in sub-acute forms of this syndrome. It is quite possible that a child who is infected develops this but not badly enough to be brought to a physician and diagnosed. Considering how Americans get upset about potential disease processes that have demonstrated miniscule risk, what response can we expect if this is now recognized as a long-term consequence of a child who is infected with SARS-CoV-2.

So, what can we do? One should seek immediate medical care for a child who has:
• Prolonged fever (more than five days)
• Difficulty feeding (infants) or is too sick to drink fluids
• Severe abdominal pain, diarrhea or vomiting
• Change in skin color – becoming pale, patchy and/or blue
• Trouble breathing or is breathing very quickly
• Racing heart or chest pain
• Decreased amount of frequency in urine
• Lethargy, irritability or confusion
Early recognition by pediatricians and referral to a specialist including critical care is essential.

Additionally, we need to reopen smartly. Based on news reports, pictures, and videos there appear to be a very large number of people who haven’t gotten the message about the requirements to remain open.
One, things will close down again if the transmission rate of the disease goes above 1.0. If we close down after opening because of a spike of cases many economists say that economic disruption could be worse than we have seen so far. Therefore, prevent spread!

This can be easily done by following all social distancing regulations and recommendations. Flaunting these may make someone feel empowered but it is only putting their health and the health of all those around them at risk. Possibly more important to those who are behaving badly, flaunting will lead to more infections which will lead to a new shutdown which will lead to continued economic pain.

Stay safe. Be smart.

STERNBERG: Opening Will Take To Mid-July

LIFE IN THE TIME OF COVID-19

Opening Will Take

Until Mid-July

Richard Sternberg, a retired Bassett Hospital orthopedic surgeon, has agreed to provide his professional perspective while the coronavirus threat continues. Dr. Sternberg, who is also a village trustee, resides in Cooperstown.

On Sunday, April 26, Governor Cuomo outlined the general plan for re-opening the Upstate economy at his daily briefing. A front-page article in this week’s Freeman’s Journal & Hometown Oneonta outlines what he said.

There are a number of conditions to the various phases of the opening. I will explain how they might affect us in Otsego County.

NY PAUSE lasts at least until May 15. Then “phase one” may begin in lower risk regions of the state. I assume this will include the Mohawk Valley region, which includes Otsego County, since we have the second lowest rate positive antibody testing in New York State: 1.7 percent. New York City has 25 percent.

“Phase one” will include opening construction and manufacturing functions with low risk. Employers will have to ensure that proper distancing and safety issues are addressed.

Hopefully, in Otsego County and the surrounding areas, this will mean that hospitals can start doing elective surgery and bring their activities back to normal since, by far, healthcare is the biggest industry in our area, about 10 times larger than tourism, and local healthcare providers have been hemorrhaging money that they can ill afford.

“Phase one” will continue and after two weeks there will be a two-week pause to evaluate what effect this has on the incidence of new COVID-19 cases.

“Phase two” would begin after the two-week break – that is four weeks after “phase one” began and would open certain additional industries and businesses based on priority and risk level. After two weeks there would be another two-week break before advancing to Phase Three.

In essence each step would be in force four weeks before advancing to the next. Presumably additional steps would include opening schools and other businesses.

Finally, what appears to be the last to re-open are what are called “attractive nuisances,” that is activities and events that would attract large groups especially from outside the region or state. Note though, based on the governor’s outline, we don’t begin to reach this stage until eight weeks from the end of the pause on May 15, i.e. July 10.

Based on my reckoning the absolute earliest we could consider bringing back tourists is the middle of July, and then we won’t know about this until we reach that point. There is a good chance that schools will open on time in the fall but it doesn’t look likely that they will re-open this school year.

Hall of Fame Induction Weekend looks very much in doubt to me. (See related article, A1) Colleges and universities are concerned if they can re-open because of the tight living conditions and the fact that students will be coming from areas with much higher percentages of COVID cases.

All of this is predicated on people continuing to take all reasonable precautions, i.e. socially distancing and wearing masks when in public when there is a risk of approaching someone else too closely. We can help in getting a return to normal as quickly as possible by listening to and following all state and local government rules and recommendations.

Stay safe.

Trustees Votes to Strengthen Anti-Bigotry Proclamation

Trustees Votes to Strengthen

Anti-Bigotry Proclamation

By JENNIFER HILL• Special to www.AllOTSEGO.com

Sternberg

COOPERSTOWN –Two weeks after high school boys allegedly attacked another student and shouted homophobic slurs, the Cooperstown Board of Trustees voted in its meeting this morning “unanimously and loudly” to strengthen a 2016 proclamation that the village welcomes people of all backgrounds and does not tolerate acts of bigotry.

“I think it’s important to reiterate how much we in Cooperstown deplore racist and homophobic behavior,” said Richard Sternberg, one of the Trustees who spearheaded the action and vote.  “I found it very heartening we did this.”

Final Count Underway In Sheriff’s Race, More

Final Count Underway

In Sheriff’s Race, More

The final canvass in the Nov. 6 midterms – the counting of 1,665 absentee ballots and 319 affidavit ballots – is underway this morning at the Otsego County Board of Elections at the Meadows Office Building.  Seated at center are Richard Sternberg, observing on behalf of the county Democrats, and Lynn Krogh, on behalf of the Republicans.  Others, from left, are Democrat Maguire Benton, Republican Bobby Walker, Marty Rosenbaum on behalf of Assemblyman Bill Magee’s campaign, and Nick Wilcock on behalf of John Salka, who is leading Magee in the 121st Assembly district count.  The greatest interest is in the county sheriff’s race, with incumbent Rich Devlin leading by 1,039 votes, but challenger Bob Fernandez refusing to concede.   The ballots would have to break two to one for Fernandez for the retired state trooper to unseat Devlin.  (Jim Kevliin/AllOTSEGO.com)
Cooperstown Vigil Honors Victims In Pennsylvania, Kentucky

13 Candles Lit For Victims

In Pennsylvania, Kentucky

Cooperstown faith leaders Rev. Dane Boston, Rev. LaDana Clark, Rev. Joseph Perdue, Rev. Elsie Rhodes, Pastor Sharon Rankins-Burd and Father John Rosson and Kris Gildenblatt stand in solidarity this evening at the vigil for the 11 killed at the Tree of Life Synagogue, as well as the two killed at the Kroger grocery store in Louisville, Ky, that was held at 22 Main Street this evening. (Ian Austin/AllOTSEGO.com)

By LIBBY CUDMORE • Special to www.AllOTSEGO.com

Richard Sternberg, who organized the vigil, reads his opening remarks as Kris Gildenblatt lights candles representing those lost in racist and anti-Semitic attacks last week. (Ian Austin/AllOTSEGO.com)

COOPERSTOWN – Rev. Joseph Perdue, First Baptist Church of Cooperstown, did not mince words as he read a statement from Zack Jackson, pastor, Community United Church of Christ in Reading, Penn, as part of the vigil for those killed at the Tree of Life Synagogue.

“This man who committed this massacre is a self-proclaimed Christian,” he said. “You will be tempted to say ‘He’s not a real Christian’ and feel no responsibility for him the way we do with Westboro Baptist, abortion clinic bombers and every other person who kills in Jesus’ name. It’s easy to walk away. But we must, instead, walk towards the problem of Christian extremism and face it head on!”

Candidate Diane Neal Cancels Cooperstown Appearance

Candidate Diane Neal Cancels

Today’s Talk In Cooperstown

Diane Neal

COOPERSTOWN – Diane Neal, former “Law & Order SVU” actress and an independent candidate for the 19th Congressional seat, has cancelled this afternoon’s planned 3 p.m. appearance at Cooperstown Village Hall, according to organizer Richard Sternberg, due to an illness in her family.

Sternberg said he will conducted a round table discussion about the five candidates who have appeared so far.

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