Surviving COVID-19

Northern Westchester Hospital’s Emergency Chair: 50 Percent Decline in ER Visits Impacting Patients with Life-Threatening Conditions

May 13, 2020 by Grace Bennett

Dr. James Dwyer, Chair of Emergency Medicine at Northern Westchester Hospital (NWH), discussed the alarming decline in visits to the ER among patients with serious, life-threatening medical conditions, including heart attacks, strokes, and appendicitis.

“We are seeing similar scenarios over and over again,” said Dr. Dwyer in an interview this week. “A patient, for example, who has abdominal pain is afraid to come into the Emergency Department, so they tough it out and think: ‘it will go away, it will go away..,’ and then by the time they realize it won’t, they come in with a ruptured appendix as opposed to catching the appendicitis before it’s ruptured and getting to the operating room earlier.”

Dr. James Dwyer, Chair of emergency Medicine (standing) with Michael Pancoast (seated) at the triage station just inside the emergency room at Northern Westchester Hospital.
Photo courtesy of NWH

According to Dr. Dwyer, ERs around the country are seeing a drop in overall patient volume due to patient fears about COVID-19. As a result, untold numbers of people may be dying at home or risking long-term health consequences by ignoring serious symptoms.

Meanwhile, “when appendicitis (removal of the appendix) is performed as a routine procedure, the outcomes are outstanding; most of the people are out the same day,” said Dwyer. In contrast, a life-threatening rupture can spread infection in the abdomen requiring more involved surgery and longer recovery times.

Since the pandemic started March 11, about 50% of the appendicitis cases have presented as ruptured–a normal scenario is 5-10 percent,” he elaborated. “1 in 2 ruptured versus 1 in 10… people are definitely waiting to get this taken care of.”

NWH is seeing about a 50 percent drop to their usual ER volume, Dr. Dwyer said. At NWH, the ER typically sees more than 80 patients per day and is now seeing as few as 30. “The decline in ER visits among people with serious, life-threatening conditions, including heart attacks, strokes, infections and trauma, is taking a toll on the health and wellbeing of people in the United States and around the world.

Dr. Dwyer said some patients experiencing symptoms may not be calling their doctors because they are afraid their doctors will tell them to go to the Emergency Department. “It’s possible not enough people experiencing symptoms are reaching out to their primary doctors,” he said adding that the many excellent practitioners in the area could properly discern symptoms and steer patients to the ER, as needed.

“I saw a patient who had been short of breath for six days before he decided to see his primary doctor; when he finally saw him, he found a very rapid heart rhythm, an atrial fibrillation. We immediately admitted him to the hospital.”

“We need people to understand that it is safe to go to the ER, and far more dangerous to stay home and wait for serious symptoms to disappear.”

Before coronavirus, 12% (just over one in 10) people with stroke symptoms waited one day before visiting the ER; now, 25% (one in four) wait at least one day, despite symptoms that can include loss of vision, speech, sensations and weakness on one side.

Surviving stroke, he explained, is very time dependent. “For those who present early– within 4.5 hours–we can give medication that breaks up the clot. The window for treating more severe stroke–via an endovascular procedure to open up the blood vessel–is traditionally within six hours, and in a small minority of cases, up to 24 hours.”

“The earlier you get these therapies, the more successful they are at preventing a bad outcome,” he said.

“We want people to know that it’s safe to visit the ER,” he emphasized. “At NWH, people are screened at the front door of the Emergency Department, everyone in the entire institution wears a mask, and patients are treated in private rooms.”

Dr. Dwyer added: “The precautions we take here are working. Very few staff members have been diagnosed with COVID since this started.” Dr. Dwyer also pointed out that only a small number of visitors are allowed in the hospital so as to protect overall populations. These include partners of women giving birth, parents to a pediatric patient, and close family members to those dying of COVID-19 or any other condition.

As of this morning (May 13), NWH was caring for 19 COVID-positive patients in the hospital, which is significantly down,” Dr. Dwyer said. “We were up in the 80s at the beginning of April, so it has come down quite a bit. We still have 10 people on ventilators who are COVID positive. Some of these critically ill people require an extended period of time for their lungs to recover on the ventilator.”

“We happen to have had some success treating patients on ventilators. The 10,000th discharge from Northwell in fact was from Northern Westchester Hospital, someone who was severely infected who is now recovering.”

“From our institution alone, we have had 247 live covid discharges. That’s very encouraging.” There have been 58 COVID-related mortalities.

Dr. Dwyer elaborated: “We have worked very, very hard to make sure this is a safe environment, and in the ER, especially. When you come into the ER, you are screened at the door, and given a surgical mask and then escorted to one of 26 private rooms–there is very little chance of being exposed to COVID at NWH.

He pointed out that his nine-year-old nephew was a patient recently. “He had a laceration. He had cut his ear on a branch outside running around–he came into the ER, and one of the nurse practitioners sewed his ear up. I feel comfortable having my own family here.”

Dr. Dwyer urges people to recognize the signs and symptoms of the following life- threatening conditions:

Heart attack

People who survive a heart attack may have weakened heart muscles and are at risk for life-threatening complications including another more serious heart attack. Go to the ER immediately if you have any of the following symptoms:

Chest pain, including tightness, and pain that spreads to the arms, neck, jaw or back;
Sudden onset of shortness of breath, sweating, dizziness or lightheadedness;
Unexplained nausea, indigestion, or heartburn.

Strokes

When caught early, immediate treatment may prevent death and minimize the long-term effects of a stroke. Even if a stroke is minor, it is important to receive an evaluation and treatment in order to prevent another, possibly devastating, stroke: Go to the ER immediately if you have any of the following symptoms:

Body weakness, especially on one side;
Facial droop;
Difficulty speaking or finding words;
Sudden loss of vision;
Numbness or loss of sensation;
Unsteadiness on your feet.

Appendicitis

When caught early, a surgeon can remove the appendix and often send you home the same day. If the appendix ruptures, a patient will spend days in the hospital and be at risk of life-threatening conditions that include peritonitis and sepsis. Go to the ER if you have the following symptoms:

Pain in the right lower quadrant of the abdomen (which typically increases when you move and intensifies over 24 to 48 hours), sometimes with
Loss of appetite;
Nausea and vomiting;
Fever.

The Experience of Being a Single Mom and Going it Solo during COVID-19

May 7, 2020 by Inside Press

The following was written on April 13, 2020, as an FYI, and edited here for publishing clarity. Three plus weeks later, the feelings are pretty much status quo, although I’ve settled into more of a routine, which helps. Like many, I imagine I’d be in a state of acute despair without Governor Cuomo’s daily briefings or summaries.

I simply wish to bear witness to my personal experience as a Single American, Empty Nest mom staying home solo and doing my best to follow the new COVID-19 rules.

My 23-year-old son lived with me for Month 1 of ‘all this.’ Renewed bonds, his humor, mine too, all helped ease the transition to this ‘new way.’ I loved having him here, in fact, after two plus years since starting empty nest in earnest (that is, post his graduation from college when he moved into the city permanently).

It may appear at first glance that I rescued him bringing him home to the burbs after he developed mild symptoms, got diagnosed as positive with COVID-19, and recovered here, but I know the truth now.

A certain household structure of cooking and meal preparation is comforting and calming. Permission to and the ability to take care of a loved one are absolute gifts, too.

Please never take any of that for granted, ever, not for a minute.

So…

This one is for all the single people living in what boils down to, what is amounting to, a stretch of house arrest.

But ok, without the ankle bracelet.

Yes, social media and FaceTime calls with kids, family and special friends help. It has been especially heartening to keep up with my daughter almost daily as I had been feeling we had grown apart. She has taught herself new skills, and I’m planning on blaring about them soon too, if she’ll let me.

Yes, absolutely, a Zoom meeting or the sometimes seemingly infinite number of fitness or meditation classes and musicians and entertainers and political/educational forums online breaks things up and absolutely does help with motivation or to keep spirits up.

I’d have been lost for a stretch without private stretching/exercise sessions with a therapist from New Castle Physical Therapy for a back-related issue.

Laughter has been key to so many getting through this, so trust me that all the funny online posts in goofy Facebook groups or from all the self styled comedians out there are amazing lifelines for me, too.

I marvel at all the ingenuity and entrepreneurship and ponder the transforming future of where we will all land in the realm of real time versus virtual time.

Still.. I spend a lot of time online for my work, so I look forward to getting off line… so there’s that. Ultimately, online communication is not like having humans in proximity in your home-whether it’s hearing the sound of a voice or seeing the gleam in someone’s eye. If you are a people person, which I am, by and large, the absence of ‘actual’ time together is felt deeply.

If you don’t own a pet, which I don’t anymore (a long story for another day, perhaps), yes, it’s far worse than that.

I hear a lot: “I can’t imagine not having my dog through this (or dogs, or cat, or cats).”

Well, imagine it. Many single people do not have pets for a variety of reasons. At this juncture, I don’t have a pet. Not even a fish. And that is that, too. I am not looking for leads on getting a pet, so please, dear reader, do not go there. It actually hurts for you to. I’m fully aware of the options, and let’s just say, it’s complicated.

For me, all I know is that today is Day 10 of alone during COVID-19. For many, it’s well into the 20s, 30s or even 40 plus days. I contemplate the continued impact of long-term isolation.

Whether it’s your kid’s groan when you tell him to get back to his homework, or your spouse or significant other yelling out, “What’s for dinner?”, please don’t underestimate the value and comfort of a voice that’s in proximity to you. I wonder: Will I settle into isolation? Will it get easier? Harder? Impossible to bear?

I am a person who considers my mental health as intact, stable as she goes. But anxiety is taking hold now, and I’m keeping a variety of toll-free numbers handy.

The days are much easier than the nights. I am intensely grateful to live where there are many neighbors in proximity, at least. I take my near daily walk for the people and pet visuals, for the dose of Vitamin D, too. The sun sustains me like nothing else. I appreciate even a wave from six feet away at the occasional neighbor, or even someone’s puppy or dog wagging its tail.

Neighbors’ eyes sparkle and even the wrinkles surrounding them ‘speak’ to me from above the bridge of a nose and circumference of a mask. If they are not wearing masks, I keep my distance, wave anyway, and pray they simply stay safe, too.

I like getting into my car for the reminder of the old normal as I set about to perform only the most necessary errands. I gratefully take in the ‘hum’ and ‘sounds’ of the market, or at the pharmacy, too. Those fill the soul some, too.

When night falls, a certain fear takes hold, a sense of vulnerability that’s hard to explain. Maybe it’s when all these feelings of aloneness peak. Watching TV, binge watching especially, helps a good deal. I mourn the end of any good series! When I turn the net and TV off, though, it’s me again, and… the pockets of dark space. I’ll slog through some darkness, contemplate the dishes in the sink, but usually choose to leave them for the morning. I try to reduce the night hours by going to sleep as early as possible. Sleep is a bit of a messy affair, too, also the subject of a future post.

I won’t venture too much here into the lack of touch or intimacy and the total weirdness of virtual dating, or rather, foregoing virtual dating, for the most part. For reasons also best left to another column, perhaps, I will say I don’t feel this is the time to embark on new romance, either. For personal reasons, I wasn’t necessarily ready for new romance before COVID-19, and I don’t believe that has changed. If anything, those feelings are exacerbated. Still, I’ve always been in the never say never school, too.

I don’t want pity, but compassion and understanding are great. I don’t need advice or suggestions either. Or maybe I do. I don’t know.

I understand my feelings are unique too, and not universal. An old friend, similarly alone, is not experiencing it this way at all, and even expressed a comfort level with the isolation, so go figure. She describes herself as perhaps always having been an introvert and that somehow ‘all this’ is suiting her. I would describe myself as more of an extrovert (although a shy one, too, in a way, as contradictory as that may sound), so perhaps we are hit a bit harder. Then again, I always loved my alone time, too, but by design. And choice. So, again, I don’t know.

I am not writing this to compare pain and painful situations. The tragedy is devastating and on some days, beyond all comprehension. The disease has hit terribly hard taking tens of thousands of lives across the country, hundreds of thousands across the world, and threatening the health of family members, roommates, as it devastates nursing home residences, in particular. Prison populations have also been horribly impacted. And so on. Solo in my otherwise comfortable suburban pad is certainly also better than any domestically violent situation in any socio-economic circumstance.

And yet, what I want to convey, is that pain is relative, and that the pain here is real for me, too.

Human beings are largely social creatures. Our souls are tested, and I believe shrink in any prolonged isolation. I want to erase the stigma too that anyone weathering this solo is similarly feeling. I know that I’m not alone with these feelings, and that they are widespread.

And yes, yes. I am still counting my blessings to be alive and healthy. I was never going to even share these words as I worry they may sound somewhat self indulgent or morose. But then again, if a pandemic is not the time to feel those things too, then I don’t know what is. You are welcome to search elsewhere for inspiring and uplifting right now. I have tried to keep busy sharing all the drama and news I possibly can through this press on a most limited budget. I have plenty of work to do to make sure my 17-year-old business survives COVID-19. I’ll overshare too that it can feel like wading through molasses. I go through all the steps I’m advised to take as a small business and wait for those to bear fruit. And wait. I have rooms and a garage I promised myself I could declutter now, but somehow, paralyzed to, since that feels like the ultimate solo punishment.

I write this simply to self-express (that helps me, so forgive me if my oversharing causes you any discomfort). Finally, I share also to express that I do feel empathy for everyone weathering this storm. My heart goes out to all of you, to those single and to those in semi full or very full houses (maybe we can trade places for a day?) and all your own unique challenges. And yes, I must believe that we too can get through this, #AloneTogether, and #NewYorkTough. Or when you’re not feeling so tough sometimes, too.

Individual Mask Making Efforts are Making a Difference too

April 27, 2020 by Lauren Rosh

Last in a Three-Part Series Spotlighting Mask-Making Efforts

Stopping the Spread of COVID-19 One Mask at a Time

As the first two parts of our series on the efforts to create ‘PPE’ communicated, there are tens of thousands of masks and now additional gear being produced in highly coordinated efforts by Tri-State Mask Making and Masks and More. Over the course of writing this series, we also learned of impressive individual efforts taking place. Arlete Chaves and Mara Antonio are among those who did not expect to be sewing masks for family, neighbors, employers and friends. Chaves and Antonio donate to those urgently in need, or for the most minimal fees. Each day, they are still fielding requests from many eager to have every day protection.

Arlete Chaves is a babysitter and dog sitter in Ossining. She learned there was a mask shortage and knew people were in need of them. She took matters into her own hands and began making masks. The skills she developed from sewing doll dresses as a young girl translate well into making secure and sterile masks.

She has made over 100 so far, primarily donating the masks to elderly people in her community, those who are immunocompromised and those working in essential businesses such as supermarkets.

Chaves is also selling them for $10 a mask to people locally. She needs to sell in order to continue to buy materials for the masks she sews and donates. She advertises mainly on Facebook.

“I want to help as much as I can and that is why I am sewing masks. I see people in need and this way I can give them an opportunity to not get sick or if they are sick to not spread it to others,” said Chaves.

With big heart intentions too, Mara Antonio of Chappaqua began sewing masks after she heard about the Joann Fabric Make-to-Give initiative which encouraged people to pick up curbside kits to make masks and donate them to those who need them.

Antonio went twice to Peekskill to pick up the kits in the morning, completed them within a day and returned them the next morning ready for more.

From 2001 to 2011, Antonio worked at Susan Lawrence. As she was using the kits from Joann’s, someone close to her from Susan Lawrence asked if she would consider making masks for their employees.

“I agreed and I realized that I needed to re-organize my sewing/craft corner and be ready for more demand,” said Antonio.

She started by making the masks for Susan Lawrence and one of her friends who is a firefighter who posted the masks on the Chappaqua Moms page on Facebook. From that moment on, her initiative took off. She fulfills orders and makes an extra mask per order to donate to the Cancer Center at Northern Westchester Hospital.

Antonio wakes up at 8:30 a.m., quickly eats breakfast, turns on her favorite radio station from Argentina which is where she is from and begins sewing. She responds to questions, requests and sends pictures to her customers with fabric designs they can choose from.

Antonio takes occasional breaks to eat brief meals or take her dogs for a walk. She sews until about 3:30 a.m. then packages the orders, organizes her materials and places orders for materials that are running low. Antonio does not go to sleep until about 4 a.m. She has personally sewn hundreds of masks now.

“I don’t like to rush, I like whatever I make to be neatly made and presentable. It is a process from sourcing the materials, washing and drying fabrics prior to cutting for shrinkage and sanitation,” said Antonio.

Antonio sells the masks for $15 each to people locally. She purchases all materials out of pocket and places all of the fabric orders herself. She uses the money she makes from each mask to buy more materials so she can keep making them.

Antonio ensures that each time she puts a delivery out in the mailbox she disinfects the mailbox in order to avoid cross contamination. She runs this whole operation herself and is devoted to this initiative.

“It’s just me making these babies and I am loving every minute of it,” said Antonio.

Tri-State Mask Makers Seeking New Recruits

April 25, 2020 by Lauren Rosh

Second in a three-part series focusing on community efforts to provide healthcare personnel and individuals protective masks against the coronavirus.

Nurses at White Plains Hospital wearing masks from Tri-State Mask Makers

Cristina Lee of Chappaqua is the driving force behind the Tri-State Mask Makers. She started the group locally and Faina Tsipenyuk and Paty Bella joined her at the beginning. From the first day, people from New Jersey, Connecticut and other parts of New York joined the initiative.

Lee is originally from Taiwan and has access to news from Taiwan, China and Hong Kong. In January, her contacts informed her about the need to wear masks to stop the spread.

“I tried to tell people to wear masks but I was deemed panicking or alarmist because it was against CDC’s recommendation. So, when I saw healthcare workers crying that they cannot get N95, I jumped in and started our group on March 20th,” said Lee.

Originally, hospitals did not take the fabric masks. In order to make masks more acceptable, Lee created a slideshow with all the information to help people better understand the importance of these fabric masks. Soon, hospitals began taking them.

The group has been continuing to develop different models of masks and covers and partnered with Sew-for-NY and Sew-for-CT, websites developed by Jeanhee Chung. These are organizations that people can contact if they would like to volunteer or are in need of masks. After signing up, the organization connects them to their local groups. All masks sewn by the members of Tri-State Mask Making Group are made by 100% cotton fabric, mostly new fabric. The cost of these materials is high, so they are fundraising to get materials for local sewists and groups.

As of the morning of April 25, Tri-State Mask members reported sewing about 15,000 masks–bringing the total of masks made by groups locally to about 50,000.

The mask total includes about…
10,000 made by Larchmont/Mamaroneck Masks for New York
3,000 made by Neighbors For Refugees
7,000 made by Masks & More
6,000 made by Cotton Candy Fabrics (CT)
7,000 made by Croton Mask Makers
11,000 by Kim Mulcahy, Sew Happy Members and Rye Moms
1,560 by Project Face Masks in New York City
1,000 by Nita DV and her team
1,000 by Westchester County Mask Makers led by Ivy Eisenberg
2,200 masks and 350 caps by Pleasantville group, lead by Carolyn Ramsey
2,370 by Sew-for-CT
and still counting.

Tri-State Mask Making group members distribute their masks to hospitals, group homes, nursing homes and prisons. Some of these include the White Plains Hospital, Brookdale Hospital, the pediatric nursing division at Montefiore Hospital in the Bronx, Cerebral Palsy of Westchester, Richmond Community Services, Bethel’s Nursing & Rehabilitation Center and Cedar Manor.

Lee publicized that she was looking for people who sew in the area to help out. That’s when Jane Sheinfeld jumped on board. Sheinfeld is the owner of The Pieced Palette, a gift store that sells fabric gifts and accessories.

Her strengths involve buying the fabrics, sewing prototypes and typing up instructions. Sheinfeld also has access to fabrics at a wholesale price.

The group is now moving in a new direction. They are planning on serving as a funnel for new recruits to connect them with local leaders or assigning them tasks, serving as a place for people to share new ideas and innovations, facilitating access to materials, purchasing in bulk to then donate to groups and fostering local groups.

“Our sincere goal is to facilitate anyone who wants to volunteer, no matter their abilities. They can all help,” said Lee.

The motto with these initiatives is the more people involved the better. Sheinfeld said there is no pride in ownership in this community, it is all about helping others.

“If you want to start a group, start it. It’s very fluid as long as everyone has the goal in mind that people need masks and they should be made correctly,” said Sheinfeld.

This group is continuing to grow by pairing up with other people such as Lina Serpico who is offering pre-cut kits and guides to new sewers and Alexandra Rosenberg who has been working on spreading the word to the PTA.

All materials are donated so if you would like to contribute to the cause you can find their fundraiser link for supplies here: https://www.gofundme.com/f/7fu6e-mask-making-supplies

If you would like to get involved or would like a copy of mask making instructions please email: maskmakerstristate@gmail.com

If you would like to donate sewn masks, please bring them to Toni Magnotta at Chappaqua Cleaners & Tailors. Curbside pickup is available.

MASKS & MORE: A Heartening County & Community Response is Helping Provide Personal Protective Equipment

April 23, 2020 by Lauren Rosh

The Demand for Personal Protective Equipment is High and People from Every Corner in the County are Helping Out.

FIRST in a Three-Part Series about efforts underway to protect those on the frontlines.

Right now, people are searching for ways to slow the spread of the coronavirus. In Westchester, and across the world, people are coming together to make masks and other PPE for their neighbors, those who are immunocompromised and frontline heroes. Despite being separate groups, there is no sense of competition among them. They are their own unified community; all just people who want to help those around them. Here’s a look at one such initiative that started in Westchester County that you can be a part of.

Masks & More: A Group Effort

Aparna Paladugu and Morris Mayer organized a Westchester-wide mask making effort called Masks & More. Armonk resident Laurie Anderson joined their team as a Northern Westchester coordinator. “It is unbelievable to me that our healthcare workers had to throw a plea online to get what they need. We just want to help,” said Anderson.

Mayer owns Park Plaza Interiors and when he closed his shop in Mamaroneck due to the pandemic, he devoted the space to making masks and transformed his home into a distribution center. His shop sews about 1,000 masks a week for health care workers on the frontlines and others in need.

Paladugu is a retired psychiatrist who now coordinates, organizes and communicates with everyone involved with Masks & More. Mayer’s neighbor who wanted to start making masks contacted Paladugu. After talking to Mayer, the two decided to combine their efforts. All masks that Masks & More makes go to Mayer’s home for distribution.

“We make sure we have a contact at the hospital or health care facility. It is key so the masks make it to where they need to go,” said Anderson.

Medical residents Drs David Iffy and Ashish Goel at Brookdale University Hospital, Brooklyn, wearing efforts of Mask & More volunteers. Cotton Masks go over and help protect scarce N-95 masks.

Caroline Loeb of Mount Kisco in her home sewing masks for frontline warriors.

They have distributed more than 6,000 masks in Westchester, New York, New Jersey, Michigan and Tennessee. As of April 18, via a nationwide network of upholstery shops that Mayer is a part of, 70,592 masks were made and distributed across the United States.

“We would not be so successful today in making masks and distributing without the enthusiasm of so many volunteers who selflessly started sewing using their own funds to buy material and make masks,” said Paladugu.

The group makes two different types of masks: one with a pocket for frontline workers and one without for seniors or health care workers not on the frontlines. Anderson’s main responsibility is a runner. She makes sure everyone has what they need and delivers the masks.

Nextdoor is an online platform where people can link up with others in their area to get information about goods and services. Anderson got involved with Paladugu and Mayer’s efforts after seeing a doctor post on Nextdoor asking for masks.

Since transforming his store into a distribution center, Mayer has been paying his employees and paying for materials out of pocket and funds are running low. For more information and to donate, please visit: https://www.smilesforsaige.com/plaza-park-interiors

If you would like to get involved, please visit: https://docs.google.com/forms/d/1F_04aoZ7Af09yAJ9rAAS0I57Fqg3BIUlOTMU78s6NI8/viewform?edit_requested=true

Plus, here, a video on how to make masks for health care workers. Volunteers Katie and Eric Rauch created this for Masks & More.

Surviving COVID-19

Northern Westchester Hospital’s Emergency Chair: 50 Percent Decline in ER Visits Impacting Patients with Life-Threatening Conditions