Public officials are working across state lines to piece together an expanding and increasingly complex puzzle when it comes to coronavirus in New Jersey, with cases diagnosed in six counties as of Monday and exposure linked to populated areas like New York City; Westchester County, New York and Boston.
The number of cases of coronavirus disease, or COVID-19, has ramped up quickly in recent days in the Garden State and throughout the tri-state region — as public health experts predicted — prompting New Jersey leaders to focus additional attention on strategies to mitigate the impact of the virus on local communities, in addition to continuing their efforts to prevent or contain its spread entirely.
Monday evening, Gov. Phil Murphy declared a public health emergency across all 21 counties, signing an executive order that provides greater flexibility and additional resources for the response. “The State of New Jersey is committed to deploying every available resource, across all levels of government, to help respond to the spread of COVID-19 and keep our residents informed,” Murphy said.
Of the 45 tests administered so far in New Jersey, 11 have come back positive for COVID-19, a flu-like infection that can cause mild symptoms in most patients, but has proven deadly for some elderly or immune-compromised individuals. The virus has infected more than 113,000 people worldwide, including at least 600 in the United States, nearly two-dozen of whom have died.
As of now, decisions about how to employ those mitigation strategies — like closing schools and cancelling gatherings — are being made by state officials on a case-by-case basis, or left to county and local officials, health care leaders and the business community. Public health officials said the number of cases and transmission patterns did not yet warrant statewide bans and closures, but they plan to discuss the options at a task force meeting today.
Persichilli: Additional cases ‘not unexpected’
“The fact that we’re continuing to see additional cases is concerning, but it is not unexpected. It follows the trend that we’re seeing around the rest of the country and in fact the world,” said state Department of Health Commissioner Judith Persichilli, a nurse and former hospital executive, at a briefing Monday with Lt. Gov. Sheila Oliver and state and local public health officials.
“Based on these developments today, we will be increasing or strengthening our public health strategy to include not only all of our containment steps, but to look at mitigation interventions” as well, Persichilli said. These could include widespread school closings, telecommuting requirements, or screening visitors at nursing homes, she added, noting that mitigations are designed to control the spread, while containment is about stopping transmission.
“At this time there does not seem to be sustained community transmission, in light of what we’re seeing,” noted state epidemiologist Dr. Christina Tan. But the state continues to monitor the situation closely, she said.
While Oliver, Persichilli and others urged the public not to panic, Monday’s briefing seemed to signal a shift in the state’s actions and the tone of its public message. (Officials also shared significantly more detail on the COVID-19 cases detected, after being harshly criticized last week for what some called a lack of transparency.) The governor’s state-of-emergency declaration only underscored the seeming new urgency; the order also allows the state to expedite certain procurement processes to obtain necessary supplies.
Keep a two-week supply of necessities
Persichilli reminded the public to keep at least a two-week supply of food, water and medication on hand — including over-the-counter drugs to reduce fever — in case they should have to self-quarantine. She later stressed this is proper emergency preparedness protocol at any time. “If you need to isolate, we’re suggesting everyone be prepared,” Persichilli said.
For residents in some areas, like Bergen County — home to at least four cases of COVID-19 — daily life could be impacted sooner rather than later. County Executive Jim Tedesco said his administration is working with state and local health officials to implement a mitigation plan that makes sense for local communities.
“Mitigation is an effort to reduce the loss of life and rapid spread of the virus by lessening the impact of the coronavirus disease,” Tedesco said. “In order for mitigation to be effective, we need to take action now, before the outbreak becomes a health crisis, (in order) to reduce human consequences.”
Department of Health leaders also made clear that COVID-19 numbers would continue to escalate as more people are screened, but stressed that statewide closures and mass testing do not make sense at this time for New Jersey. Frequent testing can give people a false sense of security, Tan said, since some may get negative results but subsequently develop symptoms.
“We also have to consider the judicious use of these tests, in the context of limited resources, in the context of trying to prioritize where we want to focus our attention,” Tan added, noting that tests are being reserved for those who are at higher risk or more likely to have been infected. “That’s why the emphasis has always been on the self-quarantine, on taking those everyday steps (like washing hands, covering coughs and staying home if sick) you can do in the meanwhile,” she said.
‘Everyone does not need to be tested’
Dr. Brian Strom, chancellor of Rutgers University Biomedical and Health Sciences programs, agreed there is no current need for widespread testing. “Everyone does not need to be tested for coronavirus,” he said in a video-link to an unrelated press conference held earlier Monday with U.S. Rep. Frank Pallone (D-NJ.) “For everyone who gets sick, the chances are overwhelming that you have a cold or the flu,” he said. “Let’s save the (coronavirus) tests for those who really need it.”
Testing capacity has been hampered by early malfunctions in the kits developed by the federal Centers for Disease Control and Prevention and delays in getting effective tests distributed to state labs. New Jersey now has enough tests in stock to test more than 400 people, according to assistant health commissioner Chris Neuwirth, and has ordered enough to test another 216 people from the CDC.
As of Monday, two private lab companies — LabCorp and Quest — also began testing samples collected by health care professionals. Details of how this private testing process works in New Jersey were not available late Monday afternoon, but DOH said LabCorp processed one of the 11 positive tests administered here; the other ten were run by the state lab. (Scientists at Hackensack Meridian Health and Rutgers University said they are also working on tests they hope can be put to use soon.)
When results come back positive, the specimens are sent to the CDC lab in Atlanta for backup testing. But, as of Monday, the CDC had yet to confirm any of the “presumptive positives” identified in New Jersey and Neuwirth said state officials have been unable to determine what is causing the holdup.
DOH officials urged members of the public to check out the department’s coronavirus webpage or call the state’s poison center 24/7 hotline, 1-800-222-1222. The department has also created an email address for questions about the virus: firstname.lastname@example.org
“If we all remain calm and informed with each passing day and just practice common sense, the risk of an individual contracting coronavirus remains low,” Oliver said.