‘No one was prepared’: N.J.’s top health officials assess the year of COVID-19

Lilo H. Stainton

In an interview, New Jersey Health Commissioner Judy Persichilli talks long-term care issues, vaccination program, and what lies ahead.

This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

A failure of imagination.

That was one of the factors that initially plagued the government response to COVID-19 in New Jersey and nationwide, according to state Health Commissioner Judy Persichilli and Dr. Eddy Bresnitz, the medical adviser for the state’s coronavirus response.

Persichilli and Bresnitz joined NJ Spotlight News on Friday to talk about what they learned in battling the coronavirus, which emerged in New Jersey a year ago this week.

Many resources were scarce at the start, they recalled, including COVID-19 tests, hospital beds, and protective gowns and masks, something Persichilli, a nurse and former hospital executive, called “unfathomable” in the richest nation on earth.

But Bresnitz said it was a failure of imagination that hampered the ability of politicians and public health leaders to fully comprehend the velocity at which the virus would spread. As a result, the system didn’t respond at the speed or scale needed to effectively contain or slow the infection.

“March 4th was the first case in Bergen County,” Persichilli said, and the infection was later connected to a family gathering in Monmouth County. “Within two weeks, five (participants) were hospitalized and eventually expired and 19 had tested positive,” she said, all linked to that initial diagnosis.

A year after COVID-19 was first identified in New Jersey, the state has recorded nearly 800,000 cases and almost 24,000 fatalities linked to the disease. “No one was prepared for what we experienced this year. No one imagined that,” Bresnitz, the former state epidemiologist, said. “We just couldn’t imagine it would turn out to what it would be.”

In the interview with NJ Spotlight News, Persichilli and Bresnitz also talked about the challenges in controlling the viral spread in long-term care — New Jersey experienced one of the highest death rates in the nation in nursing homes — and in rolling out the state’s COVID-19 vaccine program, which has experienced overwhelming demand. They also shared their thoughts on the importance of public messaging during a pandemic and what they hope COVID-19 and public health will look like in the years to come.

On the unique nature of the virus

Persichilli recalled that epidemiologists in the state Department of Health were familiar with other strains of coronavirus, which can cause common colds. But it quickly became clear this form of the virus was far more contagious and dangerous, unlike anything she or others had experienced before.

“I harken back to when we started finding HIV/AIDS,” Persichilli said, noting that she was then working at a hospital that treated a prison population in which that disease was spreading quickly. “We saw in a very short period of time going from five cases to 55 cases in the hospital, and I remember thinking back then, this is really something. And that was nothing,” she said, when compared to what we’ve experienced with COVID-19.

Rethinking steps on long-term care

Pershichilli was criticized for implementing federal recommendations that called for nursing homes to accept COVID-19 patients discharged from hospitals — either residents or individuals in need of rehabilitation — if operators could separate and protect everyone. Within two days of the March 31 order, 200 facilities informed the health department they could not safely accommodate these discharged patients, forcing the state to scramble for additional options.

“Was it the readmission that caused the spread (in long-term care facilities) or was it already there? Probably a combination, to be blunt,” Pershichilli said. “If we knew then what we know now, curtailing admissions and visitation” from friends and family earlier than it was “probably would have saved lives,” she said.

Public frustration with vaccination program

To prepare for the vaccine rollout, Persichilli said the state beefed up the capacity of its existing immunization tracking system and, after considering the options, tapped a vendor — Microsoft — to build a registration and scheduling system for vaccinations. But the system was quickly overwhelmed by unexpected demand and with only limited vaccine supplies coming from the federal government, public frustration has soared.

“I don’t think we realized when we brought it up that immediately 2.5 million people would register. We knew there was a lot of vaccine hesitancy in New Jersey; we’re known for our vaccine hesitancy,” Persichilli said. “And immediately over 2 million people registered, at a time when we were getting very little vaccine.”

COVID-19 in the years to come

Bresnitz said that, with the rollout of the vaccine — and continued use of tools like masks and social distancing — life will be far more “manageable” by this fall. “The real question for me is not where we will be with COVID-19 at the end of the year, it’s where will we be in a few years. Will we have the willpower, will our elected officials have the willpower — at the federal level, at the state level, at the local level — to sustain the capabilities that we’ve built up,” he wondered.

“There’s a lot of money coming into the states. There’s a lot of money going out to build the infrastructure. But my experience in the past is, this goes up and down, it’s like a roller coaster when it comes to support. And as we get further and further away from the crisis and the trauma we’re experiencing, memories get short. especially when there are other competing demands,” he said.

A message for frontline health care workers

Persichilli said the support for public health infrastructure that developed because of the pandemic is “the best thing that’s come out of this,” and something that must continue. Her pride in the frontline workers who have battled the virus is clear.

“We will never forget this,” she says. “I tell the people working (for the state) and at the hospital and at long-term care, ‘You’re not living through history, you’re making history. Be proud of that. Because you are improving things.’”