Health commissioner: We have ‘expectation’ that community spread has occurred

After days of discussing the possibility — and the concern — surrounding community spread of coronavirus, New Jersey Health Commissioner Judith Persichilli said in her daily media briefing Wednesday that it likely has come to New Jersey.

Persichilli announced that the state has eight new presumptive cases of COVID-19, offering only scant details about county, gender and age. But she did say two of the cases have no known connection to community spread at this time.

Community spread is apparent when cases occur with people who have no known contact to others with the illness or travel to areas where the illness is highly prevalent.

“The investigation of these cases has just started, so contact tracing is not available at this time,” she said. “However, we do know that two of these cases do not have exposure to COVID-19, either a confirmed case of COVID-19 or travel from an area that has had community spread of COVID-19.”

The new cases come from Bergen (four), Middlesex (two) and Monmouth (two) counties. There are five males and three females. And they range from ages 17-66.

Persichilli said 37 patients are currently under investigation, with 20 of them having had a specimen sent to the state lab for testing.

“Simply put, community spread is defined as person-to-person transmission without exposure to a confirmed case or a nexus to an area where community spread is identified,” she said. “We’re looking at all of our cases as the contact tracing comes in, to assure that there are a majority of cases that have a confirmed exposure.

“For those who do not have a confirmed exposure, we are putting them under further investigation. The reason being: Community spread indicates that the coronavirus is among us. And we have an expectation that that may be the case.

“So, although I do not have that analysis today, which can point us in that direction of community spread, we are stepping up our mitigation strategies in selected areas.”

Because of this, Persichilli said, the state has increased its rules and regulations surrounding visitors to some psychiatric hospitals, elder-care facilities and specialized pediatric residential facilities.

“Our goal right now is to restrict all visiting unless there is a patient at end of life or hospice and requires support, or if there is a mental health condition that would be worsened if the visitor is not allowed in,” she said. “However, no one will be allowed in if they have a fever, they have a cough, if they have any respiratory symptons — or if they have traveled from an area that has had community spread.”

Persichilli — like Gov. Phil Murphy said earlier Wednesday — indicated the state is not ready to make more severe restrictions to the general public.

“For mitigation interventions, such as widespread school closures, canceling of events and controlling sporting events, all of that will be determined on a case-by-case basis,” she said. “Our guidance right now is to encourage people to limit those type of activities as much as possible.”

State officials announced New Jersey will be receiving $14 million in federal grants from the Centers for Disease Control to assist in its efforts.

Persichilli touched on a number of issues during an approximately hourlong briefing:

On the state’s ability to test: Perschillli said the state has the ability to test 400 specimens (it currently has tested 80).

On hospitals having enough personal protective equipment for their staff: “At this point, (hospitals) appear to have enough PPE for the present cases that they are seeing,” Persichilli said. “Our biggest concern, quite frankly, is the personal protective equipment over time.  If a surge occurs, which we expect it may, I think we will be certainly constrained in our availability of supplies.”

On the watershed moment when the state will definitely have community spread and bigger issues: “I don’t know where that turn is, but I know the epidemiologists will tell you that we want to respond sooner than later, and we will know when it’s time to take our mitigation strategies to the next level,” she said. “They do remind us that what happens in a certain community may not happen in another.”

On why this is being viewed with such severity, considering far more people die from the flu each year: “The biggest thing is there is no vaccine for this,” Persichilli said. “The reason why we are so very concerned is because this is a new situation that we are seeing and we’re still in the process of trying characterize what the scope of illness is.”

“It’s a novel virus. The concern is because it is a novel virus. When something new is exhibited in humans, we follow it very carefully, but it’s difficult to make overall assumptions. It’s a big population and, at this point, we still think that the risk is low, but we’re watching it. I can’t sugarcoat that.”

On the readiness of hospitals: “We’ve done an inventory of our negative pressure rooms and we know we have capacity for 700 cases,” she said. “The hospitals all have emergency preparedness plans. They’ve all identified what stockpiles they have of personal protective equipment.”

On a surge of patients to an emergency room: “We’re looking at the surges in emergency rooms, which is the biggest issue right now. People coming in, worried, that want to be tested. I understand why they’re there. They’re scared. So, we’re looking at some alternatives for surge. EDs that can be easily constructed around the state if needed. We have two that we know are already licensed. They were licensed during a prior epidemic and they’re prepared to go online. We’re looking at more of that.”

State epidemiologist Christina Tan gave advice on how those who self-quarantine should be treated.

“After individuals who are asked to self-quarantine complete their 14 days, they are no risk to people when they go back to work,” she said. “So, it’s really important if you all can get that message out there. We want to limit stigmatization. We want to make sure people get back into the community as soon as they can.”

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