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richard sternberg

STERNBERG: Stay Vigilant! But There’s Actually Some Good News
LETTER from RICHARD STERNBERG

Stay Vigilant! But There’s

Actually Some Good News

erna
Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

This marks the 50th column I’ve written in this series.

It’s hard to believe on many levels: How long we have been restricted or locked down, that I am still doing this weekly when we figured we would need to do this for at best a few months, that there remain new things to write about (in fact, every week brings new information), that my publisher makes me pay for my own subscription.

I am very grateful to my readers who have given me useful feedback, my publisher for giving me a forum to spread this information, and to my daughter who is a real scientific editor and has helped me with advice and, at times, review of my work.

In celebration, I’ve decided to write a column with good news for a change. (This is NOT to mean that we don’t still have to be vigilant, maintain masks and social distancing, avoid crowds, etc.)

Just that there’s finally some good news to write about.

►In a study of 600,000 people in Israel, which has vaccinated a higher proportion of its population than any other country, there has been a 94-percent drop in symptomatic COVID-19 infections. The vaccinated group was also 92-percent less likely to develop the severe form of the illness if present.

STERNBERG: Vaccine? Terrific. But What About Treatment
LETTER from RICHARD STERNBERG

Vaccine? Terrific. But

What About Treatment

erna
Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

I was asked to give a talk at the Center for Continuing Adult Learning recently in Oneonta. It was supposed to be on vaccine development and distribution, but two days before I was to give it, I was asked by a participant to address treatment of active COVID-19.

Up to this point I have avoided discussing this because each physician chooses treatment for each patient based on many factors, including recommended protocols, approved medications, and most important, consideration of each patient as an individual.

Nonetheless there is some general advice from the NIH (National Institute of Health).

The NIH divides severity levels for COVID-19 into five parts with their recommendations.

►ONE: Not hospitalized, mild to moderate COVID-19.

There is insufficient evidence to recommend for or against any specific antiviral or antibody therapy.

SARS-CoV-2 neutralizing antibodies are available for outpatients who are at high risk of disease progression.

Antibodies bind to the virus, block its ability to get into a cell, and trigger a response from white blood cells to come and attack the virus.

Antibodies could be natural or manufactured. Dexamethasone is a steroid anti-inflammatory which is approved in more severe stages and should not be used here.

►TWO: Hospitalized but does not require supplemental oxygen.

Dexamethasone should not be used. There are insufficient data to recommend for or against the routine use of Remdesivir. (Remdesivir is a drug specifically to treat viral diseases). For patients at high risk for disease progression, the use of Remdesivir may be appropriate. (Yes, I too find this statement very confusing.)

►THREE: Hospitalized and requires supplemental oxygen, but does not require high-flow oxygenation, mechanical ventilation, or an ECMO (extracorporeal membrane oxygenator – sort of like a heart/lung machine used in open heart surgery).

Use one of the following three options: Remdesivir for patients who require minimal oxygenation, Dexamethasone and Remdesivir for patients who require increasing amounts of supplemental oxygenation, or Dexamethasone alone when combination therapy cannot be used or if remdesivir is not available.

►FOUR: Hospitalized and requires oxygen through a high-flow device or non-invasive ventilation. Use one of the following options; dexamethasone or dexamethasone and remdesivir.

►FIVE: Hospitalized and require mechanical ventilation or ECMO. Use dexamethasone.

There are other drugs that have been considered for use in COVID-19.

One is Invermectin. Others are monoclonal (all one type) antibodies as described above. Another drug fluvoxamine (Fluvox) is a drug used for obsessive-convulsive disorder and was hypothesized to block excessive inflammatory reactions.

Bottom line if sick is, find a physician who you trust. A good physician will listen to a patient’s concerns and questions and then when you are comfortable with them, your best shot is to follow their instructions.

STERNBERG: J&J Comes To The Rescue! And What About That NFL
LETTER from RICHARD STERNBERG

J&J Comes To The Rescue!

And What About That NFL

erna
Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

On Friday, Jan. 29, Janssen/Johnson & Johnson announced its vaccine had proven effective in Phase 3 studies. This brings a third vaccine on line in the fight against COVID-19 and potentially increases the pace of vaccinations by 50 percent.

Additionally, the J&J protocol is for a single dose and the storage requirements are much less stringent than those of the two vaccines already available in the United States, Moderna and Pfizer.

On the other hand, the statistics on efficacy for the J&J vaccine are not as high as those reported for the other two. It is reported as 85 percent effective globally against severe disease and 70
percent effective against moderate to severe disease.

Many scientists consider this on balance very good news.

If we remember back to last year the goal for efficacy was 70 percent which would have made that equivalent to the flu vaccine. Only because of higher numbers with Moderna and Pfizer do 85 percent and 70 percent seem low.

Furthermore, the J&J vaccine is a one-dose regimen and requires only basic refrigeration to last for weeks, making it much easier to distribute and complete a course of vaccine (i.e., only one shot).

This should especially help in people hesitant to get a shot at all.

Working The System, Getting The Shot
LETTER from RICHARD STERNBERG

Working The System, Getting The Shot

erna
Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

I had my first COVID-19 vaccination Sunday, Jan. 26. To get an appointment, I went through all the protocols and algorithms that I discussed previously in this column.

I was able to find an appointment Sunday in Plattsburgh. A day later I found an appointment for Utica on Feb. 3 and canceled the Plattsburgh appointment and then I kept looking for something closer and sooner.

Lucky for me, some close friends were also going through the various procedures and last Friday, Jan. 24, they found Kinney Drugs in Richfield Springs was scheduling appointments for the next two days; this past weekend.

They had just scheduled theirs and immediately called me and told me about it.

I went online, followed the protocols, and filled out forms. I put in a request for an appointment for Saturday, and up popped my appointment, assigned to Sunday.

I have no complaints. In fact, that system worked better than the state system inasmuch as it asked you when you wanted an appointment but, regardless, apparently gave you the next available.

If the appointment you asked for was already taken by the time your request went in, you’d still get one without having to reenter all that information.

Unfortunately, the state Department of Health’s online registration requires you to put in a great deal of information, then you pick the time from what you saw earlier in the process, and if the appointment that was in that spot had already been taken by somebody else while you were doing the application, you have to go all the way back into the beginning to try and find next available appointment.

Somebody needs to fix their software.

STERNBERG: Here’s How You Crack NY Vaccine Scheduling

LIFE IN THE TIME OF COVID-19

Here’s How You Crack

NY Vaccine Scheduling

It Takes Determination, Stick-With-It-Ness

By RICHARD STERNBERG • Special to www.AllOTSEGO.com

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Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective to www.AllOTSEGO.com during the COVID-19
threat.

If you’re like me, and I only mean that in the COVID-phobic sense, you have been trying to figure out how to get vaccinated. I have been on-line an average of an hour a day for about two weeks trying to find appointments. Then I heard on the news that the New York State vaccination site at Jones Beach (Long Island) now has a three-month wait. What to do?

Two weeks ago, I wrote about the priorities that the state, i.e., Governor Cuomo set out. 1A was to be healthcare workers on the frontlines and nursing home residents, 1B was to be essential workers, 1C was to be people over 65 and high-risk individuals.

Then it changed, and changed again.

Every state has its own priority system. Doses have gone unused. People are flying to Miami just to get vaccinated (and maybe a little sun while they are there).

STERNBERG: COVID Transforming Calls For Better Understanding
LETTER from RICHARD STERNBERG

COVID Transforming Calls

For Better Understanding

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Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

There is a large amount of concern about this new strain of COVID that just Monday was confirmed to have reached New York State.

At this time, I keep hearing that it is more contagious than the strain we are familiar with but not more lethal.

What we don’t know, and what we will have to find out, is whether it is as sensitive to the approved vaccines as the strain we are most familiar with.

I am personally concerned that we are losing our focus on standard epidemiologic ways of preventing spread: This is not the time to give up on distancing, masks, and avoiding groups let alone crowds.

In preparing these columns, as I have stated in the past, there is a plethora of new information available every day.

There are at least 50 articles I can choose from, not including original scientific journal articles, that number several hundred each week on all platforms. None of these individual articles can give an overall picture of what is happening and the basic science in an organized fashion.

Interestingly, a close friend, an electrical engineer, turned me onto an online course offered by the Massachusetts Institute of Technology this past semester for undergraduates and graduate students. There were 13 lectures, about 45 minutes long, on many aspects of the COVID-19 crisis by experts who are leaders in their fields. The course is available to anyone online at no charge.

While some of the lectures, and lecturers, are a bit esoteric, some were quite easy to follow. Many explain things so simply and well that the average interested person can come away with a fairly complete understanding of the important points of this pandemic and how the biology behind treating it works and is implemented.

I suggest at least taking a look at it and going over some of the lecturers. I admit several of the lecturers, while leaders in their fields, had problems speaking to a non-technical audience but most of them did a good job of educating overall.

To access the course, Google “MIT course 7.00”, then hit the first listing. Individual lectures can also be found through YouTube.

I am over 40 years from studying this material as coursework and much of what we know about viruses and immunology has changed since then but as I said above, some of the lecturers were able to distill out the essence of what they were saying so that anyone with only a high school biology background could follow it.

I particularly found interesting the first lecture, “COVID-19 and the Pandemic,” the second lecture “Corona Virus Pathology” and the fourth lecture, “Insights from the Corona Virus Pandemic” (which is given by Dr. Anthony Fauci, who is a wonderful teacher)

Number 10, “Vaccines”, is also among the easiest to understand for non-technical audiences.

It is very important that all of us try to obtain as much factual knowledge as possible.

Only in this way can we make informed decisions for ourselves and our families. Taking a course like this one I describe is as equally important as to gathering information by reading individual articles.

STERNBERG: From Russia, With Love
LETTER from RICHARD STERNBERG

From Russia, With Love

Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

Unintentionally but inevitably, and catastrophically, the Russian National Figure Skating Team has carried out an experiment that lets the rest of the world see what happens when you expose super-elite athletes indiscriminately to the risk of contracting COVID-19.

While not immediately fatal, it is not pretty and suggests what the long-term consequences of contracting the disease may be for other young people.

According to the Dec. 17 edition of The Wall Street Journal, the Russian Women’s National Ice Skating team is regarded as the very best in the world and has such deep reserves of young talent that it was expected to remain the best indefinitely.

They are a very close group, literally and physically. The members of this group have pretty much disdained rules and recommendations regarding avoiding disease spread up to now.

There are social media posts of them partying without spacing or masks, posts of competition venues where very many coaches, athletes, spectators and officials are wearing their masks below their mouth or not at all, while athletes are withdrawing from the national championships because of positive tests or complications from recent positive infection.

2018 Olympic silver medalist Evgenia Medvedeva is hospitalized with serious lung damage after testing positive in November.

European Champion Alena Kostornaia missed a competition earlier in December because of a positive test has not recovered sufficiently to compete according to officials.

The National Championship was won by Anna Shcerbakova a teenager. Scherbakova herself withdrew from a late November event citing “pneumonia.” She has now won the event three times but was noted to be having trouble breathing after her programs.

Other skaters performed well below expectation. Former world champion Elizaveta Tuktamysheva who was expected to finish better came in seventh. She had announced that she had tested positive. She was reported as looking sluggish and exhausted at the Nationals.

Many who did compete had been reported as having had the virus earlier in the season. Coaches, some of who are at high risk because of age alone, have reported positive and ill.

Up until now the Russian National Federation has progressed their season as if the virus didn’t exist. Any attempts at safety protocols seem to have been ignored.

So, what do we learn from this experiment? Young people do get the disease and, when they do, they may not die from it at the same rate as the elderly but they do have medical consequences, sometimes permanently.

Why do these symptoms seem so frequent in these Russian athletes while they have not been reported with the same frequency in our general public?

Part of the answer is that these people are under a publicity magnifying glass – when they can’t perform, it is noticed. The same is evident in our professional athletes.

These are also people who have trained to perform at the extreme limits of physiologic capability, who have increased their capacities beyond normal people and therefore any slight damage to their organs whether lungs, heart, muscle, etc., are readily noticed.

The same damage is most probably occurring in the average person, but the average person does not frequently try to perform at their extreme.

While some of the Russians (and others) will never perform at elite levels again, some will have long-term damage that will affect activities of daily living. Any damage in anyone will have long-term consequences that will have heretofore unknown effects on life expectancy and long-term impairment or disability.

To those who continue to underestimate this disease, stop it. Dying is not the only bad outcome of contracting COVID-19.

I said this in April and I say it again now. Stay safe. Wear a mask. Socially distant. Stay within your pod (and if any one member doesn’t, then you all aren’t). We are getting close to getting vaccinated. Don’t screw up now.

In the NFL the lowest of the low, the New York Jets, beat the previously postseason-bound Cleveland Browns. This gave the Jets a second win and seems to knock them out of the competition for worst record and therefore first pick in the draft, according to another article on the same Journal sports page.

How could this happen?

Well, the Browns lost all their first- and most of their second-string receivers due to contact-tracing protocols for COVID-19.

The fans of the Jacksonville Jaguars, formerly the next-to-worst team in the standings, were noted to be celebrating. Now they get to draft Clemson quarterback Trevor Lawrence.

Trustees: Volunteers Could Assist With Snow Removal

Trustees: Volunteers Could

Assist With Snow Removal

By CHRYSTAL SAVAGE • Special to www.AllOTSEGO.com

Dave Karpovich’s snowblower threw an icy plume into the crisp, cold air as a winter storm dumped nearly 30 inches on the Village two weeks ago.

COOPERSTOWN – Following complaints that arose after last week’s snowstorm, the Cooperstown Village Board is once again debating snow removal from sidewalks in the village.

“There has often been a suggestion that the village take more responsibility for snow removal on sidewalks,” said Trustee Cindy Falk. “I think that those of us that have been involved in this discussion in the past understand that that needs to be done equitably.”

Cost is a factor, she said, and has stopped other municipalities in the past.

STERNBERG: Vaccines, Part II: They Arrive
LETTER from RICHARD STERNBERG

Vaccines, Part II: They Arrive

Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

I wish I had the time, stamina, and column inches to write an article daily. That’s how fast the news is coming.

Since last week, Pfizer has begun distribution and vaccinations around the nation, the Moderna vaccine has been approved and it will start distribution by the time you read this, with inoculations going into arms probably by Thursday the 24th.

The 350 Tier One healthcare workers from Bassett Healthcare will have been inoculated, though they all had to travel to either Utica or Elmira to receive the network’s allotted doses, according to a Bassett spokesman. They will get the Pfizer vaccine.

According to the Governor, we can expect more doses in the weeks ahead.

All I want for Christmas is my two vaccines.

There have been some surprises with the roll out. It seems some five dose vials of the Pfizer vaccine actually contain six doses. On the other hand, the logistics have not gone quite as well as we were told to expect. I guess that’s not a surprise.

In the United States, the priority for the order of who gets the vaccine has been announced.

Tier One-A is front-line healthcare workers and nursing home residents and staff.

Tier One-B is essential workers.

Tier One-C is high risk individuals which includes those over 60 or 65 depending on their state of residence and those with other risk factors.

After that I am not sure but it seems to be everyone else lumped together. It is not clear when and if minors will get the vaccinations, since they haven’t been tested in those under 16.

There has been some controversy over the 1-B group, not so much if essential workers should get it next, but who is an essential worker.

Overall, there are probably more than 20-30 million people in this category in the United States: police, fire, EMS, teachers, other healthcare workers who interact with the general public, grocery store workers, food processing plant workers, certain other government employees, and many others.

As someone with eight risk factors and counting, I am willing to wait my turn for most of these, but unfortunately there will be some who get moved up the list but probably don’t deserve it.

For example, an attorney friend of mine in New Jersey says they are classified as essential workers.

Shakespeare would definitely not agree. Neither do I. Some yes, but all of them? Corporate attorneys who haven’t been in a courtroom in decades and only represent clients who can pay them more than $500/hour?

There are other vaccines coming out soon. Janssen/ Johnson & Johnson, AstroZenica/Oxford, and Novavax are among those in stage three testing in the USA that may be able to get FDA approval.

China and Russia have both approved their own vaccines and are inoculating people at home and overseas.

The entire United Arab Emirates’ Tour de France winning cycling team has been inoculated with the Chinese Sinopharma vaccine.

Hopefully the vaccines from outside North America and Europe will also generate honest, reproducible data. We need every dose that can be produced that works. There are seven billion people in the world and frankly most of them would benefit by being vaccinated.

In the meantime, we can decrease deaths and slow down progression of the disease with the same simple methods that I have been advocating for nine months. (Yes, it’s that long.) Wear a mask, socially distance, don’t get lackadaisical just because you know some else well.

My god-daughter and her husband both contracted it from their 11-month-old. All are well. We just lost an Otsego citizen who caught COVID from a group home worker who contracted it at a Thanksgiving dinner.

Small group, known people. But someone died because of it. We are so close, people: Stay the course (and any other cliché you can think of).

Merry Christmas and I wish everyone a New Year that at least begins to approach sanity.

STERNBERG: Vaccines, Part I: Pfizer Into The Fray
LETTER from RICHARD STERNBERG

Vaccines, Part I:

Pfizer Into The Fray

Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

Many people have asked me to explain vaccines to them, and specifically the ones for COVID-19. They are most concerned with how they work, when they will be available, and if they will be safe.

Hopefully, this column will help.

The terms vaccine and vaccination derive from the Latin name Variola vaccinae, which means small pox of the cow. Vacca is Latin for cow.

The term vaccine was first devised by Sir Edward Jenner in 1778 based on the fact that he used an inoculation with cowpox to elicit a protective reaction to smallpox.

In 1881, Louis Pasteur proposed that the term vaccine be used to cover all new protective inoculations that were developed in order to honor Jenner.

There are multiple types of vaccines and at least one of each type has been tried or is being developed for SARS-CoV-2 (the virus that causes COVID-19).

The following are the different types of vaccines that are administered to a subject to induce a protective immune response along with examples of each.
►INACTIVATED: a dead copy of the infectant, e.g., polio

►ATTENUATED: A weakened version of the infectant, e.g., yellow fever, measles, mumps

►TOXOID: an inactivated form of the poison made by the infected cell, e.g. tetanus and diphtheria

►SUBUNIT: a portion of the protein of the infectant that cannot cause the disease by itself, e.g., hepatitis B and HPV (human papillomavirus, causes genital warts and cervical cancer).

►CONJUGATE: Weak version of the infectant, coupled with a strong antigen for something benign to increase the immune response to the weakened version, e.g., Hemophylus influenza.

►RECOMBINANT DNA, where a stand of genetic material for part of the infectant is inoculated into the host’s cells and teaches the cells to make an antigen for part of the infectant.

►RNA: This is the approach that right now is the most promising in treating SARS-CoV-2. A portion of messenger RNA is inoculated into the host cells and tells the host to make a portion of the infecting virus. This technique has not been used for human diseases clinically before.

Typically, it takes 15-20 years to bring a new vaccine to market, and less than 5 percent of candidates will succeed. The speed in which the SARS-CoV-2 vaccine has come to be distributed really is warp speed.

The first regular immunizations begin a week ago Monday in Great Britain. This is less than a year from recognition that there was a new disease and 10 months from identifying the genetic code of the virus causing it.

Currently there is only one vaccine approved for use, the one made by Pfizer and BioNTech. This is awaiting approval along with that of Moderna in the United States. Pfizer’s was approved, distributed Sunday, and injection began Monday. Approval for Moderna may come later this week.

Both of these are of the RNA type.

There are several reasons that things have moved with lightning speed.

One, the unprecedented cooperation between pharmaceutical companies and academic and government research labs.

Two, the approval of governments to allow fast-tracking such that steps of the development are done in parallel. In my mind, there is no doubt the government’s Warp Speed initiative helped move the process along.

Three, scientists have been working for 10 years on what they call pandemic preparedness. In this case they had developed a template that would allow the development of vaccines for newly emerging diseases quickly. Essentially as one scientist called it, plug and play.

In my next column I will discuss plans for the roll out and how it has gone up to that point.

Normally, the time from submission of data to approval by a government agency takes two years. In the case of SARS-CoV-2 vaccines it is one week.
After approval, time to distribution takes more than a year while the pharmaceutical companies develop and implement manufacturing plans.

Amazing what we can do when everyone is desperately pulling in the same direction.

LaCHANCE: Rotary Helps Fight Social Isolation
LETTER from CAROLE LaCHANCE

Rotary Helps Fight Social Isolation

Rotarians Katherine Dina, right, and Cathy Raddatz, left, flank the first ultrafine air filter donated by Cooperstown Rotary to the village’s Senior Community Center. Others, in back, from left, are Bev Hence, Rae Consigli, Christine McNaughton, Patricia Dilorenzo, Betty McNeil and Marti Jax. Front, from left, are Sue Straub, Enid Hinkes, Carole Lachance and Linda (Jim Kevlin/AllOTSEGO.com)

To the Editor:

Social isolation among seniors is a reality that has become an even greater concern since the onset of COVID-19.

To minimize its effects on our older population, Cooperstown Senior Community Center, CSCC, took full advantage of the sunshine and warm temperatures summer and early autumn provided.

Seniors, living in and outside of Cooperstown, have been gathering 1 – 3 p.m. Thursdays since the end of July on the lawn and parking lot of St. Mary’s at 31 Elm St.

Hand sanitizing, mask wearing and maintaining distance while outdoors provided the safe and healthy social environment much needed by seniors during this time of uncertainty.

Now thanks to the warm generosity of the Rotary Club of Cooperstown, the arrival of colder weather has not brought CSCC gatherings to an end.

Rotary President Richard Sternberg, members Cathy Raddatz and Katherine Dina received $4,000 from two grants they wrote on behalf of CSCC. This grant money has purchased three Healthway Intellipure air purifiers which utilize the ultrafine 468 air filters strongly recommended by Governor Cuomo for use in schools and hospitals.

These air purifiers, along with other precautions, create a safe and healthy environment inside the large brick building behind St. Mary’s where seniors now meet. We are so grateful to Rotary for this generous donation.

On behalf of the many who enjoy coming to CSCC, I thank Rotary Club of Cooperstown for its service and commitment to addressing the needs of our seniors within the community, as well as surrounding areas.

Carole L. LaChance
Acting CSCC Executive Director

STERNBERG: Doctor In The House (Isolated)
LETTER from RICHARD STERNBERG

STERNBERG: Doctor

In The House (Isolated)

Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

Like many of us this Thanksgiving, my family had a very truncated get together and dinner.

My daughter visited from Annapolis, Md. She had been self-isolating, had rarely gone out, always took precautions, and was tested the week before she decided to come visit.

We decided that the risk of being infected by her was very, very minimal after all of these precautions, and invited her.

I myself have been following precautions and avoiding contact except when absolutely necessary. My housemate works at Bassett Hospital. She takes all precautions and has refrained from unnecessary contact.

Once my daughter arrived Monday before Thanksgiving, our pod had no contact with any other individuals throughout her visit.

Nevertheless, we were instructed to self-isolate this past weekend.

My housemate, who has had a mild chronic cough for seven months, decided to go to the Bassett after-hours care center. She was evaluated, prescribed steroid medication and an antihistamine, and was told it was probably chronic bronchitis and she was discharged.

A COVID-19 test was taken and she was told that she needed to isolate and everyone else in her pod needed to isolate until the test came back and it could be determined whether it was positive or negative.

We were told this would take two to three days.

Personally, I felt that the probability that my housemate had active COVID-19 based on her history of present illness was no greater than that of the general population in this area.

The process she had was chronic, there were no acute changes, she showed no common symptoms of COVID-19, and she was afebrile.

Even if this had been triggered by infection with the virus, which itself was very unlikely, the active stage was long passed by many months ago.

Given the situation I was tempted and briefly considered whether the instructions were valid.

Nevertheless, we followed them to the letter and only today when the lab report came back “no detectable virus” did we stop our immediate self-quarantine.

My daughter, who had driven home is going through a two-week quarantine just for visiting, even though Cooperstown has one of the lowest rates of infection in the country right now

It’s tempting to say that we know better, we understand the odds better, or we don’t feel bad and ignore medical advice.

Nevertheless, it is critical to follow these instructions. It’s better to err on the side of caution then to assume that there aren’t any problems and proceed from that point.

The rate of infection has been going up constantly to new daily highs. The number of confirmed infections daily in the United States has been going up dramatically. The number of daily deaths is going up.

It’s still not clear how many people have actually been infected. A study last week from the CDC suggested that the actual infection rate may be up to eight times greater than the documented infection rate.

This, of course, would decrease the rate of death from the infection, since the number of deaths divided by the new number of total cases would be decreased. Nevertheless, it wouldn’t decrease the daily number of deaths due to the infection.

I was annoyed, in denial, argumentative, and generally all around ticked off to be told what to do when I didn’t think it was necessary. But that’s why we have medical professionals and of course a doctor who chooses to treat himself, has a fool for a patient.

Thankfully we got the all-clear today and we can go back to our lives albeit in the new normal. Before we did get permission to end quarantine a day of work was lost, several appointments had to be canceled or rescheduled and a pending important clinic visit for myself was in the process of being rescheduled. But it was necessary and correct in the fight against the virus.

STERNBERG: One Word Capture Mood: Sad
LIFE IN THE TIME OF COVID-19

One Word Capture Mood: Sad

The following were some of the definitions of the word “sad” from dictionary.com.

Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

“Affected by unhappiness or grief; sorrowful or mournful, expressive of or characterized by sorrow, causing sorrow; somber, dark, or dull; drab; deplorably bad, sorry.” Thesauraus.com lists 46 synonyms for sad.

And I add an additional from other sources, pathetic. The following story is sad by almost all of these. This was originally reported by CNN.
Jodi Doering, an Emergency Room nurse in Dearing, S.D., out of severe frustration and feelings of being overwhelmed, tweeted Saturday that her patients were dying of COVID-19 but remained in denial of the pandemic’s existence.

She called it a horror movie that never ends. Besides treating patients who were dying and the stress that it caused her and her colleagues, they also faced the additional emotional toll of treating patients who despite being severely ill, who while dying, still refused to acknowledge that they had been infected with a virus that they said didn’t exist.

Patients on 100-percent oxygen would swear that it was not real and many would lash out at the nurses and doctors trying to help them for trying to convince them they were dying of COVID.
There were incidents of patients screaming that it was all a fraud and that the medical staff were only wearing PPE to confuse them, that there was no need for it, and demanding that they take it off.

Rather than communicating with their loved ones before they died, they would rant against anyone or anything that tried to convince them that they were critically ill with COVID.

Cases are skyrocketing in North and South Dakota currently at a rate that is the fastest in the nation.

In North Dakota, the Republican Gov. Doug Burgum pleaded with residents, “You don’t have to believe in COVID, you don’t have to believe in a certain political party or not, you don’t have to believe whether masks work or not. Just do it because you know one thing is very real. And that 100 percent of our (hospital) capacity is being used.”

On the other hand, Kristi Noem, governor of South Dakota, has continued to oppose mask mandates or closures and has joined in antagonism to mainstream medicine.
She hosted soon-to-be ex-President Donald Trump at a tightly packed Fourth of July celebration at Mount Rushmore. Even after the president acknowledged that he had COVID-19 last month, many of his supporters continue to refuse to acknowledge it is real.

Johns Hopkins University says that the Dakotas are currently the epicenter of the pandemic in the United States, according to their and the states own data.

Experts feel that the Sturgis Motorcycle Rally, which attracted over 500,000 to South Dakota, and was encouraged by Governor Noem, was a major superspreader event.

Most of the half million did not wear masks and did not socially distance especially in bars and restaurants.

How do we stop this when so many won’t even believe it is real, or dangerous, and won’t begin to cooperate in the protection of themselves and their families?

Last night I was talking to a close friend, a college classmate who is a family physician in rural Wisconsin. He is over 65 and male like myself but otherwise has no risk factors.

He and his entire family sustained COVID-19 in October.
They are not sure what the sequence of spread was; he, his wife, and his step-daughter are all in healthcare. He said it was the sickest he ever felt.

I admit I, who has a total of seven risk factors, am scared that I may become infected. If so, I have a very significant fatality risk. Hopefully I can stay safe until there is a vaccine available to me.

I suppose I can take solace in the fact that between those that don’t believe the disease is real or that it can make them sick, and those who will refuse the vaccine, I stand a reasonable chance of getting it within six months.

STERNBERG: A New Hope On COVID-19
LIFE IN THE TIME OF COVID-19

A New Hope On COVID-19

Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

First the good news.

Joe Biden has announced his plan for dealing with the COVID-19 crisis. It will include a coordinated national plan of attack and he will be ready on Day 1, Jan. 20, 2021 to implement it. He has already announced his pandemic transition team.

Now the bad news.

One, Mitch McConnell has said the same thing about Biden that he said about President Obama in 2008, that he will oppose him in every way possible to ensure that he is only a one-term president and therefore don’t expect any cooperation from him in fighting the pandemic.

Two, Biden doesn’t take over for almost 70 days and the Trump Administration shows no signs of making any changes that could affect the acceleration of the disease.

Today (Sunday, Nov. 8) there were over 120,000 new cases nationally with over 1,000 new deaths. The estimate is that if nothing is done to change the trajectory of the disease in the U.S. then by the end of January, we could easily double the number of deaths seen so far.

In his acceptance speech Saturday night, Nov. 7., President-elect Biden said that he would name a group of leading scientists and experts as transition advisers to convert his plan into an action-plan blueprint that would start on Jan. 20, Inauguration Day.

His task force is to be led by former Surgeon General Dr. Vitek Murthy (who was fired by President Trump with two years left on his term) and former FDA administrator Dr. David Kessler.

Biden swore to empower scientists at the Centers for Disease Control & Prevention to help set national guidelines, to invest in vaccine research, and to function as one nation, meaning having a national rather than 50 individual state plans.

Ezekiel Emanuel, M.D. and adviser to Biden, said, “You’re going to have rigorous evaluation and constant refinement” of policies and strategies. There will be strict guidelines for slowing community spread.

The new administration said they would work with each governor to make mask wearing in public mandatory in their states. Current research says mask wearing alone could have saved over 100,000 Americans so far.

They plan to seriously ramp up testing. They plan to hire thousands of public health workers. They will help people to get health insurance.

They would strengthen the Affordable Care Act and immediately reopen the Market Place, something Trump has refused to do. They would create a caregiving workforce and develop resources to help health care workers with their own needs.

Most important: They would choose science over fiction.

So, Joe Biden has a very commonsensical plan for dealing with the crisis but he can’t do anything about it until Jan. 20. And then he will need the cooperation of McConnell and the governors to carry it out.

The fact that if an aggressive program is carried out then the economy can more thoroughly reopen quicker does not seem to register with a lot of politicians. And, if it does, it takes a back seat to winning future elections.

Divided government works great for the stock market and investors, at least that’s what I’ve been told and I have read. But a government that doesn’t function without a unified intent and purpose has a grave disadvantage in going to war, whether against another nation or a submicroscopic virus.

STERNBERG: In COVID Era, Makin’ Whoopee
LIFE IN THE TIME OF COVID

In COVID Era, Makin’ Whoopee

Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

Even in the throes of a major worldwide pandemic that has killed over a million people, will probably kill millions more, has damaged the health of at least as many, and caused an economic recession, there is still a need for scientific research to progress.

COVID-2 has spurred thousands of studies and research papers in all fields but I think I found the one that probably tops them all.

Every day I get at least a dozen emails of services listing articles that may be of interest to any of those interested in COVID.

In one there was listed the following article; “Benefits of Sexual Activity on Psychological, Relational and Sexual Health During the COVID-19 Breakout.”

This recently was accepted for publication in the Journal of Sexual Medicine, the official publication of the International Society of Sexual Medicine

The study was principally carried out by the chairman and members of the Section of Endocrinology & Medical Sexology (you can’t make this stuff up), Department of Systems Medicine of the University of Rome (Italy, not New York) and was relatively long at 4,700 words, not including charts, appendices, and references.

A web-based multi-question survey was used to perform a case control study; 6,821 were enrolled. Multiple statistical analysis techniques were used to analyze the data and the results were divided into different bundles.

The conclusion of the study was: “COVID-19 lockdown dramatically impacted on psychological, relational and sexual health of the population. In this scenario, sexual activity played a protective effect,
in both genders, on the quarantine-related plague of anxiety and mood disorders.”

In other words, sex is good.

Considering the large number of statistical techniques used, the slicing and dicing of the data and the amount of time this had to require, this is what their final conclusion was?

This sounds like a candidate for the late Senator William Proxmire’s Golden Fleece Awards for research of dubious value or obvious results.

Next week, back to the doom and gloom.

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