Governor Phil Murphy also ordered mass transit providers to halve their capacities; all riders and staff must wear masks and gloves, as must restaurant workers and takeout patrons.
By Matt Skoufalos | April 11, 2020
New Jersey COVID-19 Dashboard, 4-11-20. Credit: NJ Department of Health.
Another 3,599 New Jersey residents have tested positive for novel coronavirus (COVID-19), bringing the statewide total to 58,151 people, Governor Phil Murphy said Saturday.
Of those, 83 were Camden County residents.
The state also sustained another 251 deaths related to COVID-19, bringing New Jersey’s death toll to 2,183.
As residents work to “flatten the curve” of cases, sparing the overburdened state healthcare system, Murphy noted that 7,618 New Jerseyans are presently hospitalized with a confirmed or suspected case of COVID-19.
Of them, 1,746 are in intensive and critical care, and 1,650 of those are on ventilators. By 10 p.m. Friday night, another 682 patients had been discharged from hospitals throughout New Jersey.
Statewide, 111,410 COVID-19 tests have been conducted, said New Jersey Health Commissioner Judy Persichilli, of which 49,368 were positive (more than 44 percent).
After seven consecutive days of 10 percent or less growth in cases, “the good news is that means the curve is flattening,” Murphy said. “The challenging news is, it’s still going up.”
Stretching out the incidence of new cases is critical, as the healthcare system faces an imminent projected surge.
“We expect the next two-to-three weeks to be especially stressful and difficult for our hospitals and long-term care facilities,” Persichilli said.
The latest models Persichilli cited Saturday forecast 15,922 hospitalizations at the predicted peak of the virus and 3,821 patients in intensive care units (ICUs). That’s presuming social distancing helps stretch the doubling rate of new cases past the seven-to-10-day rate it’s currently hit.
Without interventions, the peak “could have been half a million cases,” the worst of which the statewide healthcare infrastructure could never have handled, the commissioner said.
“Under normal circumstances, we have 18,000 normal beds and 2,000 ICU beds,” Persichilli said, adding that she’s “been pushing to get to 4,000 ICU beds.
“I think we will have bed spaces for everyone; again, it is going to be the PPE [personal protective equipment] and the ventilators that we’re keeping a close eye on,” she said.
NJ Health Commissioner Judy Persichilli – COVID-19 Briefing – 4-10-20. Credit: NJ Pen.
Staff, resources stretched
Reflecting the severity of the acute cases in the state, Persichilli said that New Jersey has only 61 ventilators in its entire statewide inventory that haven’t yet been deployed.
Health systems have been modifying anesthesia machines to perform the same functions, which the commissioner said has delivered “the most efficient and effective results” in a pinch.
“We need ventilators, PPE, healthcare workers, beds,” Murphy said.
New Jersey has welcomed more than 18,000 medical volunteers to date, but still needs more to staff its field medical stations.
The governor made a specific appeal to any chief nursing officers, chief medical officers, physicians, and respiratory therapists.
Of those volunteers who’ve already signed up, Persichilli said that information on each has been distributed throughout the state. Details on 330 registered and licensed practical nurses (RNs and LPNs) went to facilities run by the military and Department of Veterans Affairs; details on 500 RNs went to hospitals in Central Jersey, and details on 383 others went to alternate care sites.
Cooper University Hospital in Camden. Credit: Matt Skoufalos.
Tiered care delivery as state builds capacity
The Health Commissioner described creating “a tiered system of expanding capacity” throughout New Jersey, allowing hospitals to care for the most critically ill COVID-19 patients in specific settings according to the severity of their conditions, while providing care for others “in alternative settings based on their level of need.”
“All these initiatives are dependent upon a reliable workforce,” Persichilli said.
Tiers 1 and 2 are in-hospital units for the most critically ill patients, and “those graduating out of critical care but still requiring an intensive level of care,” she said.
Tier 3 patients are those hospitalized for medical or surgical interventions unrelated to COVID-19. Those are being seen at “brick-and-mortar care sites” in Woodbury (Inspira, formerly Underwood Memorial), East Orange (East Orange General Hospital), and Paterson (Barnert Hospital), Persichilli said.
Tier 4 patients, who “need vigilance for one to five days” are being housed at three field medical sites run by the New Jersey State Police and the U.S. Army Air National Guard.
These include the Secaucus field hospital, which will be caring for 50 patients by Saturday night, and has a capacity for 250; the New Jersey Convention and Exposition Center in Edison, which is housing 20 of a possible 500 patients; and the Atlantic City Convention Center, which has a capacity of 250 patients.
Tier 5 patients are in convalescent care, which Persichilli described as “those who might be symptomatic and need to isolate,” in hotels, including healthcare workers.
Tier 6 patients will be those “asymptomatic individuals who may not have a place to go, perhaps the homeless, or other vulnerable populations,” Persichilli said. They will be housed in college dorms across the state.
The USNS Comfort also will be accepting mid-acuity medical and surgical patients from New Jersey, she said.
NJ Commissioner Phil Murphy COVID-19 Briefing 4-11-20 Case Chart. Credit: NJ Pen.
Nursing homes still tip of the spear, new regulations for mass transit, restaurant customers
Nursing homes, which have been a significant source of COVID-19 transmission, will be categorized as “COVID-capable,” “COVID-struggling,” or “COVID-negative” facilities, and can only admit new patients or readmit residents according to their ability to implement infection controls, Persichilli said.
Fifteen of the new COVID-19-related deaths have been associated with long-term care facilities, of which 305 across the state have reported at least one COVID-19 case.
The commissioner also spoke to the need for the state’s four psychiatric hospitals to develop tighter infection controls; such facilities have sustained 160 staff and 80 patient COVID-19 infections and five deaths.
Finally, Murphy also announced new restrictions on the state’s public and private mass transit carriers, asking them to “cut the capacity on all trains, buses, light rail vehicles, and paratransit vehicles” to half.
Starting Monday at 8 p.m., all riders and transit staff must wear gloves and face coverings, unless they cannot for medical reasons. Transit agencies are required to supply their staff with this equipment.
“Right now, for many of our essential workers, public transit is how they get to work, and we need to protect them during that trip,” the governor said. He expects agencies to provide specific guidance on the policies, which provide “a fair amount of discretion” for drivers.
Murphy also tightened the requirements on face coverings to all customers entering a bar or restaurant to pick up a takeout order. It’s not required for food delivered to residents’ homes, or curbside takeout. Restaurants and bars must also supply face coverings and gloves to all their food-service personnel, Murphy said.
The governor asked New Jerseyans to bear the additional discomfort to keep medical staff and those vulnerable to the virus safe.
“We accept this is inconvenient,” he said. “We accept the level of anxiety.
“I know we’re going through hell and back, but we’ll get through this, and we’ll get through this together.”
