Michael Gold and Tyler Pager

None of those efforts stemmed the severe measles outbreak that has been plaguing Rockland County in New York since October.

So on Tuesday, in an extraordinary step, the county executive, Ed Day, declared a state of emergency, effective at midnight, that would bar children and teenagers who are not vaccinated against measles from public places.

Day said he believed Rockland County’s order was the first of its kind in the United States, and several public health experts said that they could not recall any action like it in recent years.

The outbreak has been largely concentrated in ultra-Orthodox Jewish communities in Rockland, many of which have close ties to Brooklyn areas where there have also been infections. In both communities, vaccination rates tend to be lower, and anti-vaccination literature has spread, public officials have said.

The declaration highlighted the desperation of public officials to control the spread of a disease they have so far struggled to halt.

“We must not allow this outbreak to continue indefinitely or worsen again,” Day said. “We will not sit idly by while children in our community are at risk.”

Measles was proclaimed eliminated in the United States in 2000, but a handful of outbreaks have spread in recent years. There have been 314 confirmed measles cases in the United States in 2019, as of March 21, according to the Centers for Disease Control and Prevention.

In addition to New York, there have also been recent measles outbreaks (three or more cases) in Washington state, Texas, Illinois and California, the CDC said.

Rockland County, with a population of more than 300,000, has had 153 confirmed cases of measles since October. Of those, 48 have occurred in 2019.

Because of the scope of the outbreak and its persistence, some public health experts said they thought the county’s action made sense.

“I think this is a measure that would highlight the stakes of measles and that would put a stop to these outbreaks,” said Jason L. Schwartz, a professor of health policy and the history of medicine at the Yale School of Public Health.

While Rockland County’s health department has made strides in increasing the vaccination rate, so far, only 72.9 percent of people in the county between the ages of 1 and 18 are vaccinated, Day said.

As county officials tried to trace the outbreak, they were dismissed by some members of the community who refused to answer questions and even hung up the phone, Day said.

Day cited this behavior, which he called shockingly irresponsible, as justification for his order.

In December, Rockland County issued exclusion orders barring unvaccinated children from schools with low vaccination rates. In New York City, health officials also issued an emergency order requiring that schools in certain ZIP codes block unvaccinated students from attending class.

But as public health officials in Rockland County worked to contain the outbreak, they also found possible instances of measles exposure in supermarkets, stores and shopping centers.

On Thursday, the county’s health department warned of possible exposure this month at a Target in Spring Valley, a village of more than 30,000 people.

The order barring unvaccinated minors from public places will take effect at midnight on Tuesday and expires in 30 days. Included in the ban are restaurants, schools, shopping centers and places of worship.

Schwartz said it has been common for decades to exclude unvaccinated children from schools.

He said policies like Rockland County’s are a “logical extension” of that practice.

“When you’re thinking about ways to limit the ability of measles to circulate among the unvaccinated, it makes sense,” Schwartz said.

Dr. William Schaffner, a preventive disease specialist at the Vanderbilt University School of Medicine, said orders like Rockland County’s were a form of “social distancing.”

“They’re taking all these susceptible kids and taking them out of circulation, in effect,” he said.

Officials are particularly worried because measles is among the most contagious of the infectious diseases. The virus can live for up to two hours in the airspace where an infected person has breathed, coughed or sneezed, and up to 90 percent of nonimmunized people who are exposed to the virus will also become infected, according to the CDC.

The MMR vaccine, when given in two doses, is about 97 percent effective against measles.

Daniel Salmon, a professor at the Johns Hopkins Bloomberg School of Public Health, said the risk that the unvaccinated children would spread the disease to people who could not, for medical reasons or age, be vaccinated made Rockland County’s order reasonable.

“One could even argue they’re compelled to take action because they’re responsible for protecting the public,” he said.

Rockland County officials, Day said, do not plan on “chasing people down” and asking for proof that they are vaccinated. The prohibition will be enforced retroactively, with parents facing up to six months in jail or a fine of up to $500, or both, if they are found to have allowed unvaccinated children in public spaces.

Rabbi Yakov Horowitz, the founding dean of Yeshiva Darchei Noam in Monsey, New York, a community at the center of Rockland County’s measles outbreak, said he strongly supports vaccinations, but he is worried that the county’s declaration might lead to potential harassment, attacks and discrimination against ultra-Orthodox Jews.

Some public health law experts also expressed concern that the county’s order could infringe on civil liberties.

Lawrence O. Gostin, a professor of global health law at Georgetown University, said he found Rockland County’s emergency order deeply problematic.

He said he is a longtime proponent of making vaccines compulsory for children to attend schools, but questioned whether the order is constitutional.

“This is virtually imprisonment of a child, and certainly significantly restricting the child’s liberty,” Gostin said.

Because public health officials are given broad powers to deal with public health emergencies, it is important that they use them in ways that are not counterproductive, said Wendy E. Parmet, a professor of health policy and law at Northeastern University.

“Are you just going to make the situation in this community worse?” she asked. “Are you going to increase the distrust in health authorities?”

Still, without knowing all the specifics of Rockland County’s outbreak and the government response, she was hesitant to weigh in on the order’s constitutionality.

“This may be the rare situation where this kind of order is necessary,” Parmet said. “But in many of these cases, the devil is in the details.”

This article originally appeared in <a href="https://www.nytimes.com/2019/03/26/nyregion/measles-rockland-county.html" id="d12a4c7c-27a9-38ba-a706-9c52e1edcd9a">The New York Times</a>.

New York Suburb Declares Measles Emergency, Barring Unvaccinated Children From Public

An executive order pulled close to 6,000 unvaccinated children out of schools. Nearly 17,000 doses of the measles-mumps-rubella (MMR) vaccine were given in 26 weeks. There was a public health campaign in which community officials, doctors and rabbis testified to the importance of immunizations.

With his wife, Jennifer Hensel, he created the Avielle Foundation to support research into brain abnormalities that could be linked to violent behavior. In this endeavor, he stressed mental health education and compassion.

“Compassion is the ability to feel somebody else’s suffering, to empathize,” Richman, a neuroscientist, said in a video for the foundation. “But most importantly, it’s the hope that you can do something to alleviate that suffering.”

On Monday, Richman, 49, was found dead in an apparent suicide in the Newtown, Connecticut, building where the Avielle Foundation had an office, local police said. His death was all the more shocking given the scope of his work, community members said.

“There are no words to describe the tragic weight of today’s news,” Dan Rosenthal, the Newtown first selectman, said in a statement. “Jeremy Richman was a loving husband, father and friend to many.”

Police were called to Edmond Town Hall, a movie theater and event space that also rented offices and meeting rooms, at about 7 a.m. by contractors who were working there, said Lt. Aaron Bahamonde of the Newtown Police Department.

Upon arriving, police found a note left by Richman. Bahamonde did not disclose what the note said.

Police and the state’s medical examiner’s office were investigating the death, Bahamonde said.

Richman’s death came more than six years after a gunman stormed Sandy Hook Elementary School, killing Avielle and 25 other people, before turning the gun on himself. The massacre, on Dec. 14, 2012, thrust Newtown into the caustic national debates on gun violence, mental health and Second Amendment rights.

Some of the police officers who reported to Edmond Town Hall on Monday had responded to the school shooting, Bahamonde said.

“This is devastating to our community,” Bahamonde said. “I can’t stress that enough.”

Richman had left his job at a pharmaceutical company to focus on the foundation. He began hosting discussions and speaking at academic events about brain health and violence.

Last week, he was the keynote speaker at a summit at Florida Atlantic University, where he spoke about research that was geared toward helping people identify the symptoms of those in crisis and to support people at risk of harming themselves or others.

As the Avielle Foundation pursued grants to encourage such research, Richman spoke often with lawmakers to discuss the nonprofit’s findings and push for action.

Sen. Christopher S. Murphy, D-Conn., who is a powerful voice against gun violence, said he was devastated and heartbroken by Richman’s death. The two became close friends, Murphy said, and Richman regularly briefed staff members on Capitol Hill about his foundation’s work.

They last met in the senator’s Washington office two weeks ago.

“He seemed as excited about his work as I’d ever seen him, which makes the morning’s news so unthinkable,” Murphy said in an interview Monday.

Richman earned a doctorate in pharmacology and toxicology from the University of Arizona in 1998. He also received a bachelor’s degree in molecular and cellular biology from the university in 1992.

Before starting the Avielle Foundation, he worked in drug discovery for pharmaceutical companies in California and Connecticut.

He also had an appointment as a faculty lecturer in psychiatry at the Yale School of Medicine. In 2016, Yale’s Department of Psychiatry honored Richman and Hensel with its Research Advocacy Award.

Richman and Hensel were among the Sandy Hook families who had filed lawsuits against conspiracy theorist Alex Jones, the host of Infowars, a radio show and website. Jones has said that the Sandy Hook shooting was a hoax.

The lawsuit involving Richman and Hensel alleges that Jones embarked on a campaign of “abusive and outrageous false statements in which Jones and the other defendants have developed, amplified and perpetuated claims that the Sandy Hook massacre was staged and that the 26 families who lost loved ones that day are paid actors who faked their relatives’ deaths.”

The news of Richman’s death came shortly after two students who survived last year’s school shooting in Parkland, Florida, also died in apparent suicides.

In response to Richman’s death, the town of Newtown, the Police Department and the school system were planning to bring in mental health professionals to help the community grieve, Bahamonde said.

In addition to his wife, Richman is survived by two children, Imogen and Owen.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.

This article originally appeared in <a href="https://www.nytimes.com/2019/03/25/nyregion/sandy-hook-father-jeremy-richman.html" id="1625f1a2-f203-314f-a8ba-363126b94ead">The New York Times</a>.

Father of Sandy Hook Victim Dies in Apparent Suicide in Newtown

In the more than six years since his daughter Avielle was killed in the massacre at Sandy Hook Elementary School, Jeremy Richman had devoted his life to preventing families from experiencing the kind of tragic loss he did.

This article originally appeared in <a id="4ffe7c50-128b-4207-a40c-6ee1acfd15aa" href="https://www.nytimes.com/2019/03/26/nyregion/measles-rockland-county.html">The New York Times</a>.

New York suburb declares measles emergency, barring unvaccinated children from public

“Our hearts are shattered, and our heads are struggling to comprehend,” the foundation said in a statement.

“Tragically, his death speaks to how insidious and formidable a challenge brain health can be and how critical it is for all of us to seek help for ourselves, our loved ones and anyone who we suspect may be in need,” it continued.

Police were called to Edmond Town Hall, a movie theater and event space that also rented offices and meeting rooms, at about 7 a.m. Monday by contractors who were working there, said Lt. Aaron Bahamonde of the Newtown Police Department.

Upon arriving, police found a note left by Richman. Bahamonde did not disclose what it said.

Richman’s death came more than six years after a gunman stormed Sandy Hook Elementary School, killing Avielle, 6, and 25 other people, before turning the gun on himself. The massacre, on Dec. 14, 2012, thrust Newtown into the caustic national debates on gun control and mental health.

“It’s something that you never expect to see happen, but in the back of your mind you know that many of us are still suffering,” said Neil Heslin, whose son Jesse Lewis, 6, also died in the shooting. “He was a good friend, and it was an honor and a privilege to have known him. He did a wonderful job with the foundation, building his daughter’s legacy.”

Heslin added: “I’m sure it will rip open a lot in Newtown again. The town hall will be another tragic place here, like the school.”

After the Sandy Hook shooting, Richman expressed grief over his daughter’s death through verse, friends said. On Fridays, the day of the week that the shooting occurred, Richman posted haiku on his Facebook page. Some of the poems were haunting, including one on Dec. 5, 2015, titled “Anniversary,” which he posted beside a photograph of himself and his wife on a visit to Avielle’s grave:

What is your number

When will your heart be broken?

Mine is 12/14

But Richman also channeled his grief into action, leaving his job at a pharmaceutical company to focus full time on the foundation. He began hosting discussions and speaking at academic events about brain health and violence.

Last week, he was the keynote speaker at a summit at Florida Atlantic University, where he talked about research that was geared toward helping people identify the symptoms of those in crisis and to support people at risk of harming themselves or others.

As the Avielle Foundation pursued grants to encourage such research, Richman often spoke with lawmakers to discuss the nonprofit’s findings and push for action.

Sen. Christopher S. Murphy, D-Conn., who has been a leading advocate against gun violence, said he was devastated and heartbroken by Richman’s death. The two became close friends, Murphy said, and Richman regularly briefed staff members on Capitol Hill about his foundation’s work.

After the shooting, some conspiracy theorists targeted Richman and his family, falsely claiming that Avielle’s death was faked as part of a moneymaking scheme.

In a statement, Jones’ lawyer, Norm Pattis, said Jones “sends his condolences to Mr. Richman’s family and wishes only for peace.”

The news of Richman’s death came shortly after two students who survived last year’s school shooting in Parkland, Florida, died in apparent suicides. Their deaths sparked a discussion about suicide prevention efforts and the need for long-term resources for young people struggling to cope with trauma and loss.

In Newtown, school district administrators reached out to counselors, psychologists and social workers early Monday, alerting them to Richman’s death so they could prepare to help students and staff members grieve, according to the Newtown school superintendent, Lorrie Rodrigue.

Through his foundation, Richman had worked closely with the school district’s central office. Some Newtown High School students had also interned with the Avielle Foundation.

“I knew this was going to be very devastating to the entire community and school community,” Rodrigue said.

This article originally appeared in <a id="c84a3e82-6d47-4e07-a601-d082a163ffd6" href="https://www.nytimes.com/2019/03/25/nyregion/sandy-hook-father-jeremy-richman.html">The New York Times</a>.

Father of Sandy Hook victim dies in apparent suicide in Newtown

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Michael Gold and Tyler Pager

Articles written by the author

New York Suburb Declares Measles Emergency, Barring Unvaccinated Children From Public

Father of Sandy Hook Victim Dies in Apparent Suicide in Newtown

New York suburb declares measles emergency, barring unvaccinated children from public

Father of Sandy Hook victim dies in apparent suicide in Newtown