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This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Click here for the original article, written by Lilo H. Stainton.

Please have patience. We know it’s been a stressful year. But better times are ahead.

This was the overarching message from New Jersey health officials during an NJ Spotlight News virtual roundtable, “Vaccinating New Jersey,” which on Thursday attracted hundreds of viewers anxious to learn when and where they could get immunized against the coronavirus.

The event began with a brief message from New Jersey Department of Health Commissioner Judy Persichilli, who has led the state’s response. It then featured a panel discussion with state COVID-19 adviser Dr. Eddy Bresnitz; AARP New Jersey advocacy director Ev Liebman; union leader Milly Silva, the executive vice president of 1199SEIU United Healthcare East; and Barry Ostrowsky, president and CEO of RWJBarnabas Health, one of the state’s largest health care systems. (The author moderated the event.)

In her remarks, Persichilli outlined the state’s initiative to vaccinate some 4.7 million eligible adults, reviewed who is now eligible and noted the more than 200 immunization sites open to the public — a network she said will continue to grow once federal supplies increase.

“Be patient. I know it’s hard to be patient under the circumstances (and) people have been under a lot of stress over the last year,” said Bresnitz, who previously served as the state epidemiologist. “People are impatient, but it’s not surprising that they’re impatient,” he said, given the restrictions and isolation people have faced since March.

The following are edited excerpts from the event:

Persichilli on the virus in general: “We’ve learned a great deal over the past year and our understanding of the virus continues to evolve every day, such as the variants that we’re dealing with now, seeing it in the United States and Britain, in Brazil and in South Africa. Suffice it to say, we do learn something about this novel virus every single day.”

Persichilli on vaccine supply and goals: “With every vaccination given, we come closer to the light at the end of the tunnel where we can move beyond this epidemic. We are on our way to a better future. The wide-scale vaccination campaign is a massive undertaking. Scarcity of vaccine right now has challenged all of our states, including New Jersey.

“With a new (presidential) administration in place, we are certainly hopeful, and we have already received some word that our vaccine supply will increase slightly and continue to increase over the next several months… [The] overall goal of our plan is to vaccinate 70% of the eligible adult population in a six-month period when vaccine becomes available, widely available. That equates to between 70,000 and 80,000 vaccinations a day. Or maybe about 4,500 to 5,500 vaccinations in every county a day.”

Persichilli on demand for the vaccine: “There are currently many more people seeking vaccinations than there are appointments across the state. We continue to have a tremendous imbalance between demand and supply. More vaccine, however, will be arriving, we believe, in the coming weeks. Additionally, and hopefully, manufacturers like Johnson & Johnson will likely be authorized in the coming weeks, adding to the vaccine supply.”

Bresnitz on the numbers: “We were getting a little bit over 100,000 doses a week. I think the commissioner mentioned that we’re now going up to 130,000 a week. And that includes for both the first and the second dose. We currently have registered in our state site over 2 million people. And if you look at those who are eligible currently… we have over 4 million people right now who are eligible by those criteria. So, clearly the supply cannot meet the demand.

“We’re doing about 22,000, 23,000 (vaccinations) a day right now, not because we couldn’t do more; we are definitely set up. We have enough (sites) to handle much more vaccine. It’s really related to the limited supply coming out of the manufacturers. And having been in industry, I can assure you that the manufacturers would love to basically make more vaccine. But making a vaccine is a complicated process.”

Bresnitz on the registration system: “I want to point out that the online registration system that we have now, that has now over 2 million registrants in the space of about three weeks, did not exist at all a month or two ago; it was built from scratch.

“It started off slowly, but it will have a lot of functionality as we move along and we fix the bugs in the system. There are other states that don’t have a central registration system at all — for example, our neighbor next door, Pennsylvania; nor do they have a call center. So we’re way ahead of the game from that perspective. And we’re still very early in the distribution of vaccine.”

Liebman on seniors’ experience: “We have heard from our members that, yes, perhaps the program in our nursing homes through CVS and Walgreens has been a little slower than we might have liked. But overall, at this point, we are hearing that it is working, that the sites are being scheduled, the vaccines are being provided.

“I would say for the older residents of New Jersey who are not in those programs the experience, as we saw on the video, hasn’t been going as well. There’s a lot of frustration out there, people spending hours and days on websites. And we are hearing that frustration loud and clear. The governor has talked about how we’re building the ship as we’re sailing it. And I think that building continues.”

Liebman on access for people who are homebound: “We have to incorporate into our plan more opportunities for people to access vaccines who cannot go to vaccine sites themselves. We have a number of frail, homebound elderly who aren’t able to travel. We need to put systems in place so that we can bring vaccines to the home where necessary. I know that that is something that the department is working on.”

Ostrowsky on racism and vaccine hesitancy: “We still have many health care workers who have not availed themselves of the opportunity to get vaccinated, although they were invited first — and, frankly, had the most convenient opportunity to get it. And as we all know, many of those health care workers are disproportionately people of color and come from vulnerable communities…

“If you’re a person of color, particularly Black, your skepticism about the health care delivery system is correct. You have every right to be skeptical. There was everything from experimentation to the same disproportionate (health) outcomes that we talk about but haven’t yet fixed. So, you are rightful in your concern about taking the vaccine. We have to address that. We can’t simply try to say, ‘forget that and get the vaccine.’”

Ostrowsky on equity: “There has to be a program to, in fact, make it seamless and available to those in our vulnerable communities; that’s equity. You can’t treat everybody equally, because that’s not equity. And so investing in the special needs of people who need to be able to get to the vaccine is something we’re focusing on. … the frustration is you can activate all that and not have enough supply to vaccinate the people…

“But if we’re not guided by equity and if we’re not paying attention to vulnerable communities, we are not doing the right thing. As far as I’m concerned, that’s a simple fact.”

Silva on the ‘new normal’: “So there’s no returning back to the old normal. I think that we are, as a communal society, going to have to reimagine what our work looks like, what it looks like for us to address issues regarding health care disparities in terms of access, as well as how people are treated. (Also) how we think about the work that people do and the value that we ascribe to it and what it means in terms of the different choices that we have and how we prioritize health care, essential work, (and) investing in that workforce that provides it.

“And for all of us who are consumers of health care and also the services that are so critical to our day-to-day survival, of the people who bring us our groceries every day — what does it mean in terms of our being able to honor that work, not just in words, but also in deeds and in policy changes?”

For more information on the state’s vaccination program, go to www.covid19.nj.gov/vaccine

Information is also available by telephone, at 855-568-0545. Live operators should be available from 8 a.m. to 8 p.m., seven days a week, to assist callers directly in English or Spanish. Information can also be provided in more than 200 languages, state officials said.

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]]> COVID-19 Vaccination Plan Relies on Public and Private Health Providers https://villagegreennj.com/health/covid-19-vaccination-plan-relies-on-public-and-private-health-providers/ Sun, 01 Nov 2020 20:58:13 +0000 https://villagegreennj.com/?p=76322

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]]> Small Parties, Family Gatherings Driving Up COVID-19 Case Count https://villagegreennj.com/health/small-parties-family-gatherings-driving-up-covid-19-case-count/ Tue, 20 Oct 2020 20:50:01 +0000 https://villagegreennj.com/?p=76039

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This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Click here for the original article, written by Lilo H. Stainton.

Gov. Phil Murphy and state public health officials are concerned about a rapid rise in new COVID-19 cases in New Jersey — where daily diagnoses are now at levels not seen since late May — but said the problem is to some degree beyond their control.

Despite the reopening of schools, restaurants and other businesses in recent months, and an outbreak linked to the Orthodox Jewish community in Lakewood, state officials said Monday that much of the coronavirus spread they now see is fueled by small, private house parties and family gatherings.

“While these numbers are a far cry from where we were at our spring peaks, they are also significantly higher than where we were for much of the summer and until just a few weeks ago,” Murphy said at his regular media briefing Monday. “The capacities that we believe are contributing to the bulk of the (new) cases are those gatherings that are beyond our ability to regulate and properly enforce,” he said.

Little things still count big with COVID-19

Murphy and state Department of Health Commissioner Judy Persichilli reiterated the critical importance of basic infection control — washing hands, keeping distance, wearing masks — and urged the public to continue to be vigilant about protecting themselves against the virus, especially as cold weather forces people to spend more time inside, where it can spread more easily.

“It is understandable that residents want life to go back to normal,” Persichilli said, urging the public instead to “double down” on these protections. “The trajectory of the next few months will be determined by all of us now and in the coming weeks (and) our behavior will be critical in shaping how our holidays will be celebrated. Now is not the time to let your guard down. The virus has not stopped circulating,” she said.

New Jersey officials announced another nearly 1,200 COVID-19 diagnoses on Monday, following the addition of almost 1,300 cases on Sunday — the first time since late May that the state has recorded two days in a row with more than 1,000 new cases. Persichilli said daily new cases had remained below 300 or so all summer, but began to tick up rapidly in mid-September — similar to trends nationwide. In all, more than 221,200 state residents have been infected with the virus since March, including at least 14,425 who have died.

What is driving the new cases?

The state has invested heavily in expanding its contact-tracing corps and now has some 1,900 public health officials — nearly double the initial workforce — deployed around the state to track down individuals who test positive for COVID-19, identify who else they may have infected and reach out to those people, warning them to take precautions. New Jersey reports more data from the contact tracers’ work than many other states but has in the past declined to make public information on the places or locations associated with an outbreak.

However on Monday Persichilli shared some of these details, announcing that an analysis of 118 outbreaks tracked between March and October linked 16% of the identified cases to private gatherings — the largest percentage of location-associated cases, other than diagnoses connected to health care facilities, group living settings like nursing homes, and schools. She said 13% of cases were tied to daycare facilities and another 13% occurred among farmworkers.

“While we have seen hotspots in Ocean County (which includes Lakewood) and at our universities, overall we are seeing more widespread cases throughout the state due to community spread and not any single event or reopening step,” Persichilli said. DOH officials declined to say where they obtained the location-related case data.

What’s the state’s response?

Murphy suggested that there was little more the state could do to regulate the private gatherings that appear to be the source of the recent spread. The lockdown New Jersey put in place in March has been gradually eased, starting in late May, and most businesses can now operate at some limited capacity.

The state has also put basic restrictions on private homes, while encouraging residents to opt for outdoor events and wear masks when within 6 feet of one another other. Indoor gatherings, including those at private residences, are now limited to 25 people; funerals, weddings and memorials can include up to 150 people, or 25% of the building’s capacity, whichever is less. But enforcement options are limited, so compliance depends largely on the honor system, officials concede.

Persichilli said her team is closely watching the data reports, including the weekly COVID-19 activity reports that help indicate how rapidly the virus is spreading in six separate regions. Last week the entire map was tinted bright yellow, indicating moderate spread statewide for the first time. “We look at that every week and will continue to look at it,” she said Monday. “If it moves into the red (indicating high spread), what I think we will do is increase testing, contact tracing, isolation and quarantine.”

The DOH dispatched at least 20 additional contact tracers to help officials in Ocean County track and contain the spread in Lakewood and other communities and sent thousands of additional COVID-19 test kits to the area. On Monday, Persichilli said 212 more contact tracers would be dispatched to hard-hit regions in the next two weeks, although additional details were not immediately available.

What about rolling back the reopening?

Murphy faced multiple questions Monday from reporters wondering if he intended to shut down schools, indoor dining or other activities, in response to the rising COVID-19 diagnoses. He called the new case numbers “sobering” with “hot spots … all up and down the state” and said he regularly speaks with industry groups about how to limit exposure but insisted rolling back the economic restart was not necessary.

“We don’t have any evidence per se that indoor dining is contributing to this,” Murphy said, instead urging people to “stay strong” in their ongoing efforts to control the spread of infection. “This is in our midst. And it certainly errs on the side of indoor, private activity,” he said.

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]]> Models Predict New COVID-19 Surge Could Bring 25% More Deaths https://villagegreennj.com/health/models-predict-new-covid-19-surge-could-bring-25-more-deaths/ Wed, 14 Oct 2020 15:21:21 +0000 https://villagegreennj.com/?p=75880

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New Jersey’s hospitals could once again fill with COVID-19 patients and the state’s death toll could increase by as much as 25% by February, according to one respected national model, and that’s if people keep on wearing masks and social distancing.

If those now-common infection control mandates are eased, the number of confirmed and probable coronavirus fatalities could reach even higher — with an average of 68 people dying daily by then  — predictions from the Institute for Health Metrics and Evaluation at the University of Washington suggest.

If the public declines to wear masks and follow state public health mandates, the model predicts that come February more than 23,000 New Jerseyans may have lost their lives to COVID-19, under the worst-case scenario. If people comply with the restrictions, fatalities could be kept under 17,000, if all goes well, IHME found.

New Jersey officials have employed different modeling, using a tool called CHIME developed by the University of Pennsylvania, which state Department of Health Commissioner Judy Persichilli has said was highly accurate in its predictions related to hospital resources. The Washington university model was also relatively effective in anticipating the volume and timing of the state’s peak hospital surge, in mid-April.

The DOH did not provide specific prediction figures. But representative Dawn Thomas said, “The models are currently depicting increases in cases and hospitalizations from the virus for the late fall and winter months.”

Generally speaking, these predictive models rely on factors including coronavirus testing data, the rate of its spread, hospital capacity, historical predictors and the level of public compliance when it comes to public health restrictions, like maintaining distance and wearing masks — something that has been hard to measure, especially at the start. Persichilli told legislators last month that her team eventually settled on 50% compliance, which appeared to be accurate, in retrospect. 

Historically, public health experts have used 31% compliance as a modeling benchmark, Persichilli said — but at that rate, patients would have overwhelmed the state’s hospital capacity. She said the DOH team first started with an input of zero compliance, which predicted a flood of 80,000 COVID-19 patients at the peak this spring. Instead, the surge peaked at closer to 8,000 patients.

“I can remember the Saturday that they showed me that predictive modeling in this conference room, and I looked at the team and I said, ‘We’re not going to make it,’” Persichilli recalled in September while testifying before the Assembly Budget Committee.

‘50% social distancing saved lives’

Modeling that used a 31% compliance rate resulted in lower predictions for patient volume, but still beyond what could be accommodated by New Jersey’s 71 acute care facilities, plus the field hospitals and other sites the DOH was setting up, Persichilli said. But 50% compliance produced a number within the range of what they could handle. “That’s what we hit, on the mark,” she said. “So 50% social distancing saved lives.”

Thomas, from DOH, said they continue to run the model with compliance rates of 31% and 50%, and she stressed that many factors are considered in the process.

Credit: covid19.nj.gov On Thursday, Oct. 8, New Jersey logged an additional 1,300 COVID-19 cases — the highest daily total since late May — and added 880 more on Friday, Oct. 9.

As of Friday, nearly 3.9 million coronavirus tests had been performed in the state, and more than 212,000 New Jerseyans had tested positive for the virus, including at least 14,400 who have died.

Real-life experience has impacted the modeling in various ways, according to the DOH, although limited details were available last week.

“The state is using multiple modeling tools and analytics for cases, hospitalizations and hospital resources,” Thomas said. “As our knowledge of the virus has grown, our modeling has become more robust including multiple scenarios and factors. Using multiple scenarios allows for vigorous preparation and stockpiling in the event of a resurgence.”

1,300 new cases point to rising trends

While new daily cases and hospital volume have declined significantly since the initial surge, there have been occasional spikes, and state officials were clearly concerned about the rising trends last week. On Thursday, New Jersey logged an additional 1,300 COVID-19 cases — the highest daily total since late May — and added 880 more on Friday, with much of the increase in Monmouth and Ocean counties.

State officials suggested that while models predicted an increase, the recent spikes may be something the formulas didn’t anticipate.

“You know, this is somewhat within the modeling … of what we expected,” Murphy said at his media briefing Thursday, noting that officials were watching the numbers closely.

“With the exceptions of the hyper flare-ups that we’ve seen in places like Lakewood or at Monmouth University or Rowan (University), the modeling suggested at a certain point we’re going to start to see numbers like this,” he added.

Murphy has largely attributed the rise to indoor gatherings, not the recent reopening of restaurants or schools, and said he would take a cautious, local approach when considering reversing these steps to reopen society.

“I lean more scalpel than blunt instrument, but they both have to be on the table,” he said.

At Thursday’s briefing, Persichilli said that while case numbers are expected to go up, public compliance with the ongoing mandates can help reduce the impact on health care facilities going forward. “We are anticipating a second wave and we are preparing based on lessons learned from our prior experiences. If individuals do not adhere to social distancing, masking guidelines, washing your hands, staying home if you’re sick, this wave has the potential to become a surge,” she said.

“We know that the virus did not take a break. It is presenting itself in younger individuals who are experiencing mild and moderate symptoms,” Persichilli continued. “As the cold weather sets in and people move indoors, the threat of spread is even greater. We also know that we will be fighting this enemy for a longer period of time.”

The limits of predictive modeling

Dr. Ed Lifshitz, who heads the DOH’s communicable disease service, also said Thursday he was not surprised by the increase in new coronavirus cases, based on the modeling the department has done. But he also said the numbers from some areas were “higher than would be expected” and a cause for concern. “Modeling takes you so far; modeling is not 100% predictive as far as things go, and certainly we’re keeping a very close eye on this,” he said.

“What we’re seeing overall is spread in many different places, some associated with colleges and other places. But I do strongly want to encourage people — I know that they’re tired, I know that this is hard, I know that they’ve been doing this for a long time with all that is happening — but wear the mask, social distance,” Lifshitz said. “You need to do this continually, regularly, all the time. You always need to be thinking about it.”

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