How ready is NJ if COVID-19 surges again?

LILO H. STAINTON, HEALTH CARE WRITER | MARCH 24, 2022 

NJ Spotlight News

People waited in line to get tested for COVID-19 in Newark on Oct. 26, 2020.

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With COVID-19 case numbers down significantly since the January peak, and public and political tolerance ebbing for the pandemic and measures to control it, New Jersey is scaling back its pandemic infrastructure.

More than 1,000 COVID-19 testing locations still exist statewide, including pop-up and permanent clinics that provide free screenings, and nearly twice as many immunization sites, according to the state Department of Health. But just two of the six testing mega-sites the department ran at the height of the pandemic remain, one of which is open just a single day a week. Counties have also reduced the days and hours testing and vaccinations are available through their programs.

Less contact tracing?

The health department also plans to eliminate half of the nearly 2,000 COVID-19 contact tracers now employed by the state to track the viral spread this month, with hundreds more to be let go by June, according to county officials who had been told about the changes by the state. Health department officials declined to comment on their plans to reduce the number of contact tracers but said monitoring systems largely remain in place and the public will continue to have access to data on COVID-19 cases, hospitalizations, deaths and other metrics.

State and county officials said these testing sites and vaccination programs can be re-expanded quickly if needed and mega-sites could be reopened within three weeks or less, something the health department chose to do last fall when case numbers began to increase again. But some public health leaders worry these systems might not be nimble enough if New Jersey faces another sudden surge like the one triggered by the omicron variant late last year.

Concerned about ‘our ability to pivot’

“There’s two issues that are of concern to me: the introduction of variants, which are going to keep happening, and our ability to pivot to address that,” Stephanie Silvera, an epidemiologist and public health professor at Montclair State University said.

“We keep getting caught on our heels because there is historically a lack of funding for public health measures and this boom-bust cycle, where we have a crisis and we pull resources to address the (immediate issue), rather than investing in structural change,” Silvera said, echoing concerns raised in several recent reports. She fears that “we scale back to the point where when the next crisis happens, we’re already playing catch-up.”

As the impact of COVID-19 has dwindled nationwide, elected officials have embraced the opportunity to lift controversial infection control measures and encourage people to determine their own response based on personal risk factors. Gov. Phil Murphy ended New Jersey’s school and child-care mask mandate on March 7, although several large districts continue to require face coverings.

“We continue to remain vigilant and have taken significant steps to enhance preparedness,” said Dr. Edward Lifshitz, director of the health department’s communicable disease service, noting the state has created stockpiles of protective clothing and ventilators — items that were in limited supply at the pandemic’s start.

The preparations

“We also now have a better understanding of the virus, and now have an array of therapeutic and clinical treatments to support the treatment and prevention of severe outcomes. We have effective vaccines and boosters and are working to increase uptake among all those eligible,” Lifshitz continued. He said the state has distributed $90 million in federal COVID-19 funding to strengthen local public health infrastructure.

“We continue to encourage people to utilize layered prevention strategies that can protect themselves and others, including washing hands, staying home if sick, and getting vaccinated and boosted to ensure the greatest protection,” Lifshitz said. The health department also maintains a list of free testing sites on its dashboard.

More than 2 million New Jerseyans have been diagnosed with COVID-19 since March 2020 and at least 33,000 have died as a result. While new case numbers have dropped quickly in recent months, experts warn it is too soon to consider the virus endemic, or stable, in New Jersey. Variants continue to drive new spikes overseas and a so-called stealth sub-variant of omicron, BA.2, is a growing presence in the region although it has not prompted an increase in cases in this state.

“We can’t let fatigue drive decision-making,” Silvera said, warning that closures could further endanger minority groups that are more likely to be infected, hospitalized and die, when compared to white residents. “If we are scaling back access to free and low-cost testing, that’s going to disproportionately impact some groups over others,” she said. “Now you’re going to take disparities that we’ve already seen in COVID and really exacerbate them.”

The health department continues to host vaccination clinics in primarily Black and Hispanic communities, where immunization rates were lagging at first. It has also urged long-term care communities to promote booster shots among residents, who also face higher COVID-19 risk because of age and health conditions. Long-term care facilities saw some of the highest concentrations of deaths early in the pandemic.

Will there now be enough data?

Lifshitz said the state continues to collect “the necessary information to monitor and understand the current situation” from private labs and local tests sites, hospitals, nursing homes and schools.

But with less data coming in, some worry this monitoring may not paint a full picture. When the mask mandate was lifted in schools, some stopped other preventive measures, including COVID-19 testing and therefore have little to report to the state, Camden school nurse Robin Cogan said.

County testing and vaccination programs are also scaling back. In Ocean County, officials once offered vaccines and testing seven days a week at two locations. Now that happens twice a week, and county health officer Dan Regenye said he plans to further streamline those services if COVID-19 rates remain low. “We can build it up or scale it down based on demand,” he said, noting how they quickly went from three days to six days of operation when omicron was surging around Christmas.

Regenye said Ocean County could also revamp a contact tracing program it stood up in the first months of the pandemic, before the state took control of the process. Working with Ocean County College, county health officials recruited 100 tracers in several weeks and trained them on how to track the viral spread. That could be critical if cases surge again, he said.

“The state, they’re in the process of downscaling” the tracing team, Regenye said, a group that took months and millions of dollars to recruit and train. “That’s what they did last year” when cases declined in the spring “and then we got a little bit of a bind in the fall” when the virus surged, he said.

The 9/11 connection

Regenye said New Jersey’s public health monitoring has also benefited from the creation of agencies called LINCS, for Local Information Network and Communication System, which were established in the wake of 9/11 to help coordinate regional emergency response. That allowed public health agencies to standardize their practices and build capacity, he said.

“So that’s a good thing. But the bad thing is, over the course of those 20 years, that money has eroded,” Regenye added, “so some of that capacity is slowly dissolving.” Ocean County has also benefited from federal COVID-19 funding, he said — although some of that is slated to end soon — and county officials have also provided dollars when needed. “We’re in good shape from a resource perspective,” he said.

Regenye expects similar COVID-19 cycles in the year to come and he’s working with his colleagues to prepare. He also plans to use the summer to meet with local education officials to plan for a safe return to school in the fall. “If I look into my crystal ball, I think that the spring and summer will be a low point (in viral spread), so it’s just waiting for the fall when we commonly see an increase in respiratory illness,” he said.

The county’s experience with other infectious diseases, like the flu, also comes into play. Regenye said the county health department has hosted up to 100 flu-shot clinics a year, at local senior centers, assisted living facilities and other locations, and COVID-19 vaccines can be added to the menu. “We’re going to incorporate COVID vaccine into a seasonal flu model. And that’s where I think we’re in good shape,” he said.

In Gloucester County, the formerly state-overseen mega-site has been downsized and programs are now being operated by county officials at their headquarters in Sewell, county health officer Annmarie Ruiz explained. Testing is now available Monday through Friday, by appointment only, and vaccinations are administered one day a week, with appointments recommended. Ruiz said she expects this schedule to continue for the near future.

Much of the data collected in Gloucester County comes from the state, Ruiz said, as case counts, hospitalization levels and details from the statewide vaccine database. She also communicates with local schools, day-care centers, nursing homes and hospitals. “That system is still in place,” she said, “and we have the ability to expand (COVID services) if needed.”

“Our goal is to have zero cases, obviously, but I don’t foresee cases going away entirely. We’re going to have to monitor it,” Ruiz said. “Right now, we’re just following federal and state guidance and, as that changes, our infrastructure may change.”

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published this page in News and Politics 2022-03-24 03:17:17 -0700