New Jersey has yet to see any cases and state officials insist the public health system is ready to respond, but it is now a question of when — not if — coronavirus will be discovered in the Garden State.
That was one key takeaway from a briefing Gov. Phil Murphy held Monday with top health officials and other government leaders on New Jersey’s efforts to prepare for the virus that is the source of a growing global outbreak, in addition to rising public and economic panic. There are now more than 87,000 cases worldwide including at least 90 in the United States, officials said.
As of Monday, nobody in the Garden State had tested positive for the virus, COVID-19. Eight people had been screened and confirmed to be negative; a ninth person underwent testing Monday and results are pending. But administration officials said it is only a matter of time until a case is identified here.
Late last week federal officials outlined expanded screening protocols that will result in far more patients being tested for coronavirus, which experts said will result in more COVID-19 diagnoses. The new guidelines call for individuals with pneumonia from an unknown cause to be flagged for potential coronavirus testing, even if they have not been overseas or had contact with foreign travelers. This shift reflects growing concern about so-called community transmission — in which a source for someone’s infection cannot be identified — and signaled to some a turning point in the virus’s trajectory.
“With this change hospitals will be evaluating many more individuals. We are likely going to be performing more testing, as well as confirming more cases” nationwide, said state Department of Health Commissioner Judith Persichilli; she and Murphy also agreed they would “not be surprised” if some of those positive tests are in New Jersey.
Risk to general public ‘still low’
“Although this novel virus is understandably a cause for concern, it is important for New Jersey residents to know that the risk to the general public is still low,” Persichilli continued. “I want to assure you that we are taking all steps available to protect the residents of New Jersey. As this situation evolves things will change quickly and we will continue to keep you informed.”
COVID-19 is a previously unknown strain of coronavirus that emerged late last year in China and has since spread to other countries around the world, despite significant efforts to restrict transmission in some regions. It was detected in the United States roughly six weeks ago first on the West Coast and recently on the Atlantic seaboard.
The virus causes respiratory distress that frequently involves mild cold-like symptoms, sometimes coughs and, in more rare cases, significant breathing problems. Mortality is on the rise worldwide and at least a half-dozen Americans are believed to have died from COVID-19 to date.
Persichilli underscored basic infection-control practices that can help the public arm itself against infection by the coronavirus and other, far more common communicable diseases, like influenza. More than 5,000 New Jersey residents have tested positive for the flu this season, she said, and two have died.
“The same precautions you take with the flu are exactly what you should be doing to protect yourself from the coronavirus,” Persichilli said. These include washing hands for at least 20 seconds, covering coughs with your sleeve and staying home from work or school when sick; if a doctor’s visit is needed, she urged people to call first.
‘Not time to panic, but to prepare’
Murphy repeatedly stressed that it is “not time to panic, but to prepare” during his briefing on Monday, held at the Regional Operations Intelligence Center, an emergency management response hub in Ewing. In January the DOH established the agency’s crisis management team for coronavirus, which has met daily ever since, and launched a 24/7 public hotline — 1-800-222-1222. Last month Murphy signed an executive order creating a multi-agency working group that now meets weekly to coordinate state efforts with those of local and federal government and the private sector.
Last week, federal officials gave the DOH permission to perform coronavirus testing at its own labs, instead of sending samples to the Centers for Disease Control and Prevention in Atlanta. Persichilli said this means they can get results in roughly eight hours, instead of waiting days. The CDC has also provided enough test kits to last throughout the month, Persichilli said.
“My Administration is actively engaged in a multi-level, whole-of-government approach — from our hospitals, to our schools, to our ports — to implement a preparedness and response plan for the potential spread of the coronavirus in New Jersey,” Murphy said. “Together, we are prepared to respond properly and swiftly to any future individuals who meet the (CDC) guidelines for coronavirus testing.”
The DOH has also launched a webpage with a host of resources for communities, businesses and schools. Persichilli said she is working with other government officials, local health departments and hospital leaders to ensure they are planning properly for a potential outbreak.
“As you know, hospitals are on the front line of this response,” Persichilli said. “We are actively working with the (New Jersey Hospital Association) and hospitals directly to ensure they have sufficient plans in place to prepare for and respond to a surge in ill patients or a (medical goods) supply chain disruption.”
Limited re-use of certain respirators
The CDC also issued new guidance for hospitals designed to help them maintain proper stocks of medical supplies, including very limited re-use of certain respirators used by clinical staff. NJHA president and CEO Cathy Bennett, who previously served as state health commissioner, said this input allows facilities to help plan how best to protect staff and patients.
“The updated testing criteria can be helpful in improving disease surveillance,” Bennett added. “The more insight the better in honing our preparations and response.”
State Department of Education Commissioner Lamont O. Repollet, who joined Murphy’s briefing, said his department has been working to update school districts on the outbreak and urged local leaders to remain in contact with county school officials, who are serving as a conduit to the state. He reminded districts they should already have in place a policy for home instruction, consider rescheduling group events, and properly report any communicable diseases identified at school.
Repollet also reminded school officials not to allow concern about coronavirus to evolve into fear, stigma or racism against individuals of Chinese or other Asian descent. “Let’s make sure we are better than that. Stigma hurts everyone. Bullying and harassment hurt everyone,” he said.
The impact of the CDC’s new testing protocol has raised questions outside the health care sector. In a letter to Repollet calling for additional local guidance, state Sen. and minority leader Tom Kean Jr. (R-Union) said parents and district officials had contacted his office with questions about school responses. He wrote this will only grow if CDC’s warnings hold true regarding the potentially severe “disruption to daily life” that could result from more “community spread” of the virus.
DOH epidemiologist Dr. Lisa McHugh, the state’s COVID-19 response leader, stressed Monday that those flagged for screening under the new CDC guidelines do not necessarily have the disease. She also underscored that not all patients with an unknown pneumonia will be tested for coronavirus, but that health officials will conduct a secondary assessment to determine who requires more follow-up.
“The new CDC criteria that we are using is very broad,” McHugh noted. “Even though there are no cases (now) and the number of (screenings to date) remain small, as we begin to do this additional testing it does remain likely that we will identify cases in the near future.”
“I know all of this may sound like some bad news,” McHugh continued, “but the good news is we don’t have any cases in New Jersey and there are actions and preparations you can take to begin to keep your families and your communities safe.”