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How the Inadequate Supply of Protective Equipment Takes a Toll on Nurses

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Two nurses tell their stories as union rep says ‘conflicts between hospital administrators and medical staff’ are increasing

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.

Full story link – HERE.

By Ian T. Shearn

Pam Tavarone, a veteran  ICU nurse at St. Mary’s General Hospital in Passaic, suited up for work last Friday in the makeshift safety uniform she had been wearing for the past week and a half — a white Tyvek painter’s suit, goggles and an industrial-grade respirator mask — all of which she had acquired herself. Supplies of personal protection equipment at the hospital were in short supply. The heavy-duty mask had left bruises on each side of her nose from her 12-hour shifts.

But on this particular day she was uncommonly troubled. She had been experiencing tightness in her chest and shortness of breath for three days. “I could feel something was going on. It was knocking me out,” she said. Her “gut” was whispering  bad news. She has a history of asthma; two of her three daughters have underlying conditions — diabetes and asthma. She needed to be tested.

At first, “they didn’t want to give me a test, because I didn’t have a fever. But I pushed, and they gave in.” The results came back Saturday: Her gut was right; she was positive.

Now, Tavarone is quarantined in her home. At first, the hospital refused to prescribe medication for her, she said. But again, she “pushed” and they relented. She is taking hydroxychloroquine (Plaquenil), the experimental anti-viral drug, which has yet to be confirmed effective for COVID-19.

Tavarone blames no one

Tavarone is stressed, she is afraid — more for her children than herself — but remains resolute in her optimism, a common trait of ICU nurses. She blames no one. She did everything she could to protect herself, and she harbors no ill will for a hospital outmatched and overrun by the pandemic. An administrator told her that reinforcements in the form of nursing volunteers will arrive Tuesday. And “they keep tell us they’re trying” to get more gear,” she says.

Not all of her colleague feel the same way. At least three nurses at her hospital have already contracted the coronavirus, Tavarone said, and four have resigned out of fear — two walked out and two have given notice. Nurses there are given one mask and one gown per shift. Some have taken to wearing garbage bags over their flimsy plastic gowns. Fear has consumed the hospital. Morale, she says, is “sub-zero.”

“During this current COVID-19 outbreak, we are experiencing the same trials and challenges as every hospital in New Jersey and the nation,” wrote Vanessa Warner, a spokeswoman for St. Mary’s. “We are completely focused on the safety of every member of our staff and each patient they so valiantly care for.”

The depletion of personal protection equipment (PPE) and a shortage of nurses, has caused anxiety to rapidly escalate among frontline health care workers throughout New Jersey and beyond. It is a problem that won’t be solved until more PPE can be produced. But hospitals like St. Mary’s can’t close down in the middle of an outbreak because they lack protective equipment. They must soldier on.

Some nurses told to store masks between shifts

“When COVID patients first began arriving at our members’ facilities, medical workers changed gowns and masks after each encounter with an infected patient,” said Douglas Placa, executive director of JNESO District Council 1, the union that represents 5,000 nurses in New Jersey and Pennsylvania, including Tavarone (who is her local’s president). “Soon, they were instructed to  keep their protective gear on until the end of their shift. At some hospitals, nurses are now being told to store their masks in a paper bag between shifts.”

For reasons hard to understand, the dearth of masks, gloves and gowns continues to plague America. The federal stockpile is deficient and the manufacturers thus far have been unable to meet the overwhelming demand. Hospitals and state governments are engaged in international bidding wars to purchase masks for exorbitant prices. President Trump has invoked the Defense Production Act, but has not yet ordered U.S. manufacturers to produce more medical supplies.

For New Jersey nurses, it certainly did not go unnoticed when two New York city nurses died from COVID-19 in the past two weeks. New York is the epicenter of the coronavirus in the U.S., and New Jersey is ranked second. Passaic County, where St. Mary’s is located, ranks fourth in the state with 3,227 cases and 42 deaths. Cases continue to spike and both states expect that to continue for weeks.

Nurses here wonder if Europe is providing a terrifying preview of what’s in store. In Italy, France and Spain, where hospitals have been overrun by the pandemic, more than 30 health care professionals have died of the coronavirus, and thousands of others have had to self-isolate. In Italy alone, more than 11,000 medical personnel have been infected.

The message from Italian doctors

A group of doctors from a hospital in Bergamo, Italy — treating more than 4,000 COVID-19 patients with just 48 ICU beds — offered this sobering account in the New England Journal of Medicine:

“We are learning that hospitals might be the main Covid-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patients. … Health workers are asymptomatic carriers or sick without surveillance; some might die, including young people, which increases the stress of those on the front line.”

While Tavarone and her colleagues have been jerry-rigging their own safety equipment, one South Jersey nurse was reprimanded and sent home for bringing in her own mask — the coveted N95, which is in short supply across the country.

Dawn Kulach, a nurse at Virtua Voorhees Hospital in Camden County, was elated when she was recently informed her COVID-19 test result was negative. She had been placed in mandatory quarantine, suffering only from pneumonia. It meant that not just she, but her spouse and son were OK. But her relief and her sense of well-being were short lived.

When her fever subsided, she returned to work last week. Knowing the hospital was also perilously short of PPE, she turned to her personal supply. She knew the precious N95s were being kept under lock and key at their hospital and given only to those dealing directly with infected patients, which she was not. She had been able to accumulate a couple dozen N95s on her own.

As she was preparing to leave for work, her 10-year-old son started crying. He pleaded for her not to go, Kulach said. She showed him her mask, and assured him it would keep her safe.

‘Thinnest mask I have ever seen’

Upon her arrival she was taken aback when no one took her temperature, or anyone else’s, before she entered the building. She reported to her unit, a pulmonary unit that included coronavirus patients and was handed “the thinnest mask I have ever seen.” She wasn’t assigned any confirmed COVID-19 patients, but three of her patients had heavy coughs and fevers. “All safety protocols have been thrown out of the window,” she said. She put that mask over her own N95.

She was soon confronted by a supervisor, taken to a conference room with a security guard standing silently by. She was told to remove her unauthorized mask. She refused, saying “if the hospital can’t protect me, I have to protect myself, my patients and my family.” She said her manager then ordered her “to clock out and go home.” And then the kicker, according to Kulach: “She strongly suggested that I rethink my career.”

“Conflict between hospital administrators and medical staff is becoming widespread,” Placa said. “The main topic of concern is the appropriate use of PPEs and safety of our members and their patients.” Placa said he was informed by one nurse that “she was given a mask and management told, ‘Use this for the week.’”

Kulach is scheduled to meet on Tuesday with her superiors to discuss her employment status. She fears she will be fired.

She will be accompanied by a union rep and intends to tell hospital officials that “this is not what I signed up for. … I didn’t go into disaster nursing, and we are not getting any disaster pay. … I have the right to protect myself and my family. I didn’t refuse to treat patients. … If I have the means to protect myself, I’m going to.”

The collective good

If they don’t let her wear her own N95 mask, she said she simply will not return to work. “I promised my son I would wear the mask. … Maybe I will have to rethink my career.”

Dr. Reginald Blaber, executive vice president and chief clinical officer for Virtua Health, Virtua Voorhees’ parent company, declined to comment on Kulach’s situation, but did offer this: “The collective good must supersede any individual’s choice or desires during these challenging times.

“Like all health systems in the country, we are working with a limited supply and an ongoing shortage of N95s and other forms of personal protective equipment.

“Recognizing the global shortage of supplies, we must be meticulous stewards of our resources so we never find ourselves without what we need.”

Told of Kulach’s story, Tavarone was supportive: “I guess they would have sent me home every day.”

In the meantime, Tavarone is riding it out in quarantine. But now her husband has developed a cough, and she said she will “push” to get him tested. And when she recovers, she said, she will return to work.

She had lost track of the death count at St. Mary’s, but last week, before she was tested, she and her colleagues “celebrated our first success story” when one of their ICU patients became well enough to be discharged from the unit.

 

Header: Photo by Jeff Rhode / Holy Name Medical Center

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Pregnancy and Parenting in the Time of COVID

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“In motherhood, love can manifest most powerfully as fear.”  This quote is from the new book by Sarah Menkedick, with the timely title “Ordinary Insanity.” One might argue that our current situation is one of madness framing our mundane daily activities. Pregnant women and new families are living through an extraordinary historic moment doing the most ordinary things: carrying, birthing and parenting children. Yet there is nothing normal about our lives right now. This is a time of chronic concern for all humans on the planet, but for parents, especially new families who haven’t yet acquired their self-confidence as parents, it can be a recipe for anxiety.

In the past two weeks, New York area hospitals banned pregnant women’s spouses (and other romantic partners) and their midwives from assisting with births. Understandably those near their due dates panicked and scrambled to switch hospitals or flee the area; some even considered birthing at home. Then, just as abruptly, the hospitals reversed course and announced that one support person could be present at delivery. But the damage had already been done. Pregnant women now fret: “Will my hospital rules change again? Is the hospital even safe? Will I be discharged before I’m ready? What if my labor nurse is infected?”

In addition, all the fun things pregnant women expect to enjoy—a “babymoon,” yoga and childbirth classes, baby showers—have been put on hold or rearranged to comply with our solitary confinement.

This is not to say that COVID-19 has been all bad for new parents. Spending time indoors with no distractions and partners home for a potentially much longer paternity leave constitutes the perfect postpartum bubble.

But those bubbles burst with age.

“I feel like right now I’m a terrible mother and a terrible employee,” one mom confessed in a virtual support group. She’s not alone. All parents working from home are feeling divided by their pressing work and childcare obligations. Maybe in the past you spent a few days working from home when your sick child couldn’t go to daycare, but this is different. With daycares closed and babysitting help too risky, there is no reprieve; the weeks are grimly stretching out before us.

In a recent session of a support group for moms with toddlers, parents shared tips on how to create a makeshift playpen while on a conference call. “The one benefit is all of us are in the same boat—my boss, my colleagues, our CEO. It’s a great leveler.” One popular approach is for one to parent to work while the other watches the baby or children—but if you’re a single parent, this is obviously impossible. So, some single parents are leaving their homes and hunkering down with their own parents.

“I don’t know what I would have done without my mom,” says Alison, a single mother of twins. “It’s just too much for one person to juggle. We’re not supposed to work and take care of babies at the same time, but I have no choice!”  This combination of work and childcare is fueling unprecedented stress levels.

I spoke with Mollie Busino, director and psychotherapist at Mindful Power, a counseling practice in Hoboken. Many therapists have begun treating their patients in a virtual format like Zoom or Skype, and that has made counseling much more accessible. “This is a time of worry, and families need to protect themselves, especially in situations where anxiety is likely to escalate. I’m recommending that parents limit their time on social media, watching the news, and listening to a friend or relative who is consumed with panic about the Coronavirus,” Busino said.

Likewise, birth-workers, yoga instructors and other educators are creating virtual support groups to help new moms navigate this situation.

Still, parents are losing their ability to cope.  “If one more person says ‘this is the new normal’ I’m going to lose it!” says Lauren, a mother of two under age four. “I’m trying to work, my husband is trying to work, my four-year-old has no preschool to go to, and my baby is oblivious to the lack of adult attention right now.”

In Jersey City, parents are accustomed to utilizing our beautiful parks, playgrounds, interactive music and yoga classes; we have it all here, but much of that is on hold for the moment. In a recent new moms support group, I spoke to a mother of a newly toddling one-year-old, and she sounded heartbroken. “This is the time I should be watching my daughter run around, play on the swings, see her cherished friends—and we’re stuck inside with too much screen time and no fresh air.” When I suggested she go to a less-populated park (like Liberty State Park), she shrugged off the suggestion. “I think that’s worse,” she said. “Then I worry that the air we breathe, the things we touch, the person who walked—they’re all threats.”

So what to do?

Don’t let your anxiety spiral into depression. If the strain of this quarantine is starting to overwhelm you, take measures to protect yourself in the same way you would against the Coronavirus: Look for virtual new moms’ groups, seek online counseling, consider taking medication (which you may need only temporarily). Every day during this period of isolation feels long and repetitive, prompting lots of “Groundhog Day” memes. But perhaps you can connect virtually face-to-face with relatives and friends, something you might have done via only text or phoning before. Maybe you’d feel better expressing thanks—even for small, seemingly inconsequential things. I thing I can assure of you of is that this will end—and when it does, we are really going to appreciate the little things in life; we are really going to smile at that slice of pizza on the pedestrian plaza.

For help with perinatal mood disorders:

Peggy Kraft, Clinical Social Work/Therapist: https://www.psychologytoday.com/us/therapists/peggy-kraft-jersey-city-nj/122489

Mollie Busino, Psychotherapist, Mindful Power: https://www.psychologytoday.com/us/therapists/mollie-busino-hoboken-nj/77480

The Seleni Institute: Perinatal Mental Health: https://www.seleni.org/

The Motherhood Center: https://www.themotherhoodcenter.com/

Partnership for Maternal & Child Health: 973-268-2280 x 154: ygonzalez@partnershipmch.org

 

Header: Distancing in Liberty State Park, photo by Jayne Freeman

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NJ Goes All Out to Prepare for COVID-19 Surge That’s About to Hit

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In something resembling a military operation, the state is on high alert, scrambling to add critical-care beds and ready pop-up field hospitals

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.

Full story link – HERE.

By Lilo H. Stainton

After weeks of planning and preparations, New Jersey is now ready to activate its hospital-capacity contingency plans, as facilities in the northern counties are becoming increasingly overwhelmed by a surge of patients with COVID-19.

State officials are preparing to shift patients with more limited clinical needs from existing hospitals to the new “field medical station” set up by the U.S. Army Corps of Engineers in the Meadowlands in order to make room for individuals who need critical care; the field station, in Secaucus, is expected to start accepting patients Monday. Newark’s University Hospital, the region’s Level 1 trauma center, will oversee the field station and transport the patients by ambulance or air, if needed.

“As we see the number of cases increasing across the state and the pressure on our hospital systems building, we are preparing to release that valve by standing up alternative care sites,” New Jersey Department of Health Commissioner Judith Persichilli said Thursday during the state’s daily briefing on the coronavirus pandemic. Nearly 25,600 residents have tested positive for COVID-19, the resulting disease, and 537 have died.

When hospitals run out of room

The DOH has used statistical models to predict when the worst of the outbreak would hit hospitals, and Persichilli said Wednesday that, as expected, the “surge is beginning to occur in the northern part of the state.” She said the department helped several facilities secure extra ventilators before they ran out and, at points in recent days, roughly a dozen hospitals in northern counties became too full to accept new emergency patients, forcing them to “divert” ambulance traffic to other hospitals for anywhere from two to 12 hours.

“Increasing critical-care capacity is the key to managing the surge,” Persichilli said. In addition to the Secaucus field hospital, the USACE is working with the state police and others to establish additional operations in Edison and Atlantic City in the coming weeks. Altogether, this effort is expected to add nearly 1,000 hospital beds for patients who don’t need critical care.

NJTV News report on the setting up of the field hospital in Secaucus

“The hospitals are packed. We still have flu season, we still have everyone else that goes to a hospital with a medical or an emergency surgical problem,” Persichilli explained Wednesday. “That doesn’t go away during a crisis.”

New Jersey’s hospitals provide nearly 19,000 beds, plus an additional 2,000 critical-care spots. But even with the strict social distancing now in place, the models suggest the state could need an additional 2,000 critical-care beds to care for the crush of patients who are likely to suffer severe respiratory symptoms from the novel coronavirus, which is now spreading rapidly through the community. Reported COVID-19 cases jumped 15% between Wednesday and Thursday and deaths climbed by one-third, although officials said some of the fatalities may have occurred earlier in the week.

To meet the critical-care need, the state is also looking to create another 1,000 beds by reopening recently closed health care facilities, including the former Woodbury Hospital previously operated by Inspira Health in Gloucester County. St. Joseph’s Health in Paterson has pledged to reopen the former Barnert Hospital adjacent to its main hospital, which would produce another 154 beds, according to reports. State officials are also looking to repurpose unused parts of operating hospitals, hotels and other options, but declined to offer specifics Thursday, calling the effort a work in progress.

When ready, these reopened facilities will also accept lower-acuity patients “decanted” from existing hospitals, creating room for new critical-care patients. Hospital operators have been asked to double their critical-care capacity, something many have already done by rearranging facilities or reopening closed wings.

“We’ve gone through looking at every square inch of every facility that we have where we can safely put patients,” Barry Ostrowsky, president and CEO of the massive RWJBarnabas Health system, with 11 hospitals in the northern and central parts of the state, told NJ Spotlight. “When you look at the model, the need for facility-based beds and equipment will certainly outpace that which is currently available in our state,” he said.

An ‘hour-to-hour’ battle

The coronavirus pandemic is putting “unprecedented pressure on the health-care delivery system,” Ostrowsky said, and he anticipates the northern counties will “get to its crescendo and then it will hit that probably over the next two weeks. So the strain on our health care facilities, the people who staff them, the equipment and resources is literally an hour to hour, day to day, constant battle,” he said.

“We’ve been going at this seven days a week for weeks and we haven’t hit the worst of it. And that’s a scary thing,” Ostrowsky said.

While University Hospital is slated to manage the Secaucus field site, Ostrowsky said RWJBarnabas will oversee the Edison operation, which state officials said is expected to have 500 beds. The Barnabas system also includes Robert Wood Johnson University Hospital in New Brunswick, which serves as Central Jersey’s Level 1 trauma center. State officials have not said who will run the Atlantic City operation, but Cooper University Health Care, based in Camden, is the South Jersey Level 1 trauma center.

“We are honored to do it and we are uniquely qualified to it,” University Hospital president and CEO Dr. Shereef Elnahal, the former state health commissioner, told NJ Spotlight; the hospital already coordinates emergency response for Newark and its international airport and runs the busiest trauma center in the state.

Elnahal said he spoke Thursday with leaders of the other northern hospitals to coordinate plans to decant patients or shuttle ventilators and PPE to where they are needed most. The state’s emergency management team is preparing to give UH access to a regional dashboard that provides real-time information on bed capacity and equipment at northern hospitals, a system Elnahal expects will be operational early next week.

The Secaucus field hospital will start slowly and accept more patients as staff and equipment come into place, officials note. Elnahal said the Veterans Administration facility in East Orange has also agreed to take civilian patients — a first for the military site — and East Orange General Hospital, which has struggled to fill its beds, is also available to care for lower-acuity patients.

“All of that depends on the availability of equipment, supplies and staff,” he said. “There’s going to be a ramp-up (at the field hospitals), not a switch that flips on.”

Persichilli announced Wednesday that national insurance giant UnitedHealthcare has volunteered two respected clinicians to lead the alternative-capacity efforts statewide: Kathleen Stillo, president of clinical redesign, and Dr. Jeff Brenner, founder of the Camden Healthcare Coalition and a MacArthur Foundation “genius grant” recipient. State officials said they are on loan for three months.

Tracking available beds

To help coordinate the movement of patients within a region, the state is using data collected by the New Jersey Hospital Association through a portal that enables all of the state’s 71 acute care facilities to submit daily reports on their bed capacity, the size of the workforce and the availability of critical equipment, like ventilators and protective gowns and masks. Reporting began Monday and state officials said they plan to make the information public next week.

While Persichilli and Gov. Phil Murphy continue to express confidence in the state’s hospital-bed capacity — assuming the field sites and reopened facilities come online as planned — they are concerned about staff levels, ventilators and the personal protective equipment, or PPE, needed to keep health care workers safe when treating contagious patients.

The state has pushed the federal government to provide supplies from a national stockpile and is also collecting donations through its website, www.covid19.nj.gov; these items will be distributed to hospitals as needed. Persichilli’s team is also working to match 5,200 volunteers — more than a third of them licensed health care clinicians — with field hospitals or other alternative medical facilities.

While these emergency facilities are intended for lower-acuity patients, Persichilli said they will largely be able to function as full acute-care facilities, with X-ray capacity, lab services, a pharmacy and a full complement of staff, including behavioral health and social workers. The sites are not focused on COVID-19 patients, but she said they would be fully equipped to safely handle patients who develop the disease.

“We will have a full team there to meet not just the medical needs, but also the mental health needs and also the discharge-planning needs of the individuals who will be there as patients,” Persichilli said. The Meadowlands site “will be a valuable resource for our northern hospitals (that) are already experiencing an increased demand for care,” she added.

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Business Groups, State and Federal Programs Try to Help NJ’s Small Businesses Stay Afloat

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The question is whether loans, grants, tax credits and expanded unemployment benefits will be able to fully meet the growing demand for help

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.

Full story link – HERE.

By John Reitmeyer

The month of March started out fairly normal for Caruso Physical Therapy and Nutrition, LLC in Allentown, Monmouth County, but by the middle of the month, things took a major turn.

Cancellations soared amid concerns about the ongoing coronavirus outbreak, and as Gov. Phil Murphy began urging people to stay home to prevent further spread of the disease, said business owner Olivia Caruso.

Fast forward a few more weeks, and Caruso said she is now concerned about the viability of her 10-employee business, even as it has remained open, unlike many other small businesses deemed “nonessential” by the governor that have been forced to close altogether under a social-distancing executive order Murphy issued last month.

The current situation is “very scary,” said Caruso, a mother of two who is also caring for her husband as he fights brain cancer.

A huge role in state’s economy

While small businesses don’t always receive the same attention — or significant tax breaks — that often goes to large corporations, they play a huge role in the New Jersey economy, employing some 50% of those employed throughout the state during normal times.

But the coronavirus pandemic and the ongoing government response to it has made things anything but normal for the thousands of small-business owners like Caruso who are now fighting for their survival.

“We’re not bringing in enough to pay the bills,” she said in an interview this week with NJ Spotlight.

New unemployment figures the state released on Thursday shed some light on the scope of the economic damage being caused by the pandemic. A total of 206,253 new benefits claims were filed last week, according to the new unemployment data, topping the record for new claims that New Jersey set the prior week. Industries like food services and some health services like dentists’ offices, which are generally run as small businesses, were hit particularly hard.

What defines a small business is a subject of some debate, and it can vary from industry to industry. Federal data suggests small businesses with 100 or fewer employees account for the largest share of small-business employment in the U.S., but some federal programs also allow businesses with 250 or more employees to qualify as small businesses, depending on the industry.

Across the nation, new research released on Thursday by the National Federation of Independent Business (NFIB) found that 92% of the group’s members surveyed earlier in the week reported being negatively impacted by the coronavirus outbreak, with 80% of that group reporting slowed sales.

Eileen Kean, state director in New Jersey for the NFIB, said this comes as business owners already face challenges caused by the general high cost of doing business in New Jersey.

‘Struggle to survive’

“Now business owners who have spent decades building their companies face an uncertain future as they struggle to survive,” Kean said.

While federal and state lawmakers have tried to meet the new demand for unemployment benefits by boosting funding and expanding existing programs, there is also a big concern about maintaining the profitability of small businesses so that laid-off workers, including those in New Jersey, still have a job to return to when the outbreak begins to ease.

The state and federal governments have rushed out several new programs in recent weeks in response, and they’ve also found new sources of funding to support things like grants and loans, all in an effort to backstop small businesses. But it remains to be seen whether what’s been created amid the emergency will be able to fully meet the growing demand for help.

At the federal level, a number of new or expanded programs were established with small businesses in mind in the $2 trillion legislative package enacted by the Congress and President Donald Trump last week.

Forgivable loans for payroll, mortgages, rent

Among the federal offerings is a forgivable loan program that provides qualified small businesses with up to $10 million each to help cover things like payroll, including salaries and paid time off, according to Ray Cantor, vice president of government affairs at the New Jersey Business & Industry Association (NJBIA). The funding is also available for things like mortgage or rent payments, he said.

And the application process — which can be started by going to the federal Small Business Administration website — has also been streamlined to make it easier on small-business owners.

“The money should be (going) out quickly,” Cantor said.

Meanwhile, the federal government has also expanded the pool of people who can qualify for unemployment benefits to include small proprietors and independent contractors. It’s also making available tax credits for businesses to reward employee retention and changing other tax rules to help get businesses through these difficult times.

But Cantor said the new programs should be considered a stopgap, suggesting there will be many more needs that will eventually have to be reckoned with.

“There’s still a whole bunch of gaps in this,” he said.

EDA helps stabilize small business

At the state level, the New Jersey Economic Development Authority (NJEDA) just launched several new programs and expanded others to help small businesses after state lawmakers rushed out their own economic-relief package last month.

One of those programs is making grants worth up to $5,000 available to help stabilize small businesses and hopefully prevent them from having to let go of or furlough workers. Another new program is providing loans for working capital worth up to $100,000, starting with no interest for the first five years. Among other loan programs is one that’s directed at helping entrepreneurs get through the emergency.

The EDA has also created an online information hub and “eligibility wizard” to help link business owners with the benefits they may now qualify for. The window for accepting applications for the EDA’s Small Business Emergency Assistance Grant Program was just opened up on Friday morning.

“Small- and medium-sized enterprises are the heartbeat of New Jersey’s economy, and it is crucial that we do what we can to provide the resources and assistance they need to withstand the outbreak of novel coronavirus,” said Tim Sullivan, the EDA’s chief executive officer, as the programs were rolled out last week.

Chris Emigholz, vice president of government affairs at the NJBIA, called the state’s efforts “a good start,” and he credited Sullivan and other officials at the EDA for launching the new offerings so quickly.

“They put the money they had in-house on the street as soon as possible,” Emigholz said.

Putting pressure on state finances

But he also suggested more resources will be needed to help the state’s small businesses. It’s possible that more funding will be made available out of the state budget to backstop what is initially being provided by the EDA. However, just as the coronavirus has strained the business community, it’s also putting pressure on the state’s own finances as some tax sources have slowed to a trickle.

Something as simple as giving small businesses more time to turn over the sales-tax revenue they collect for the state, or at least waive penalties for paying late, may be helpful for small businesses, Emigholz said.

That recommendation and several other small-business aid proposals were included in a letter that 40 business groups, including the NJBIA, sent to Murphy and lawmakers on Thursday.

And while statewide groups like the NJBIA and the New Jersey Chamber of Commerce — which is now putting out a daily update on issues related to the coronavirus and offering other enhanced services to members — are mobilizing to help small businesses, in some places in New Jersey, local officials have also begun their own efforts.

For example, city officials in Newark have just launched a program working with the United Way of Essex County to help local businesses with 10 or fewer employees by providing them with grants worth up to $10,000 to cover things like payroll, rent, taxes and inventory. (More information about the program is available at https://uwnewark.org.)

“We can’t stand by and wait for help from other sources,” said Mayor Ras Baraka as the new program was announced last week. “Here in Newark, we must solve our own problems.”

Some efforts to support small businesses have also been launched at the grassroots level, including in Westfield, where residents are using the Westfield United Fund to provide some help to the town’s independent businesses.

First Lady’s relief efforts

A nonprofit Pandemic Relief Fund has also been launched by First Lady Tammy Murphy to help raise money for those who are being hit the hardest by the pandemic, and among those who may receive assistance through that effort will be “low- to-middle-income residents and New Jersey’s small business community,” Tammy Murphy said in a news release announcing the establishment of the new fund-raising effort.

“We are committed to the task of identifying the most effective interventions, determining community needs, and raising essential funds and awareness as we battle this challenge,” she said.

Still, despite these efforts and others, circumstances for many small businesses remain extremely difficult, as they are for Caruso, the owner of the Monmouth County small business. And Number 1 on her wish list right now, she said, is some help managing the finances.

“To help us with what we have lost, only because of the virus,” she said. “If they could just help us stay afloat through these weeks.”

 

Header:  Courtesy NJEDA Facebook page

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The Transition to Online Learning

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Honor society inductions, classes, school plays and spending time with friends: little things that most college students usually take for granted but are unable to enjoy due to the COVID-19 outbreak.

On March 16, Saint Peter’s University, a private college on JFK. Blvd. in Jersey City, suspended its face-to-face classes through the rest of the spring semester and permanently closed its residence halls on March 24. Only students under extenuating circumstances are allowed to stay.

For Matthew Goodman, a sophomore majoring in mathematics and minoring in secondary education, the transition has been bumpy. One problem has been motivation.

“… I feel less motivated working from home,” the Hoboken native said. “I need to be in a classroom to be engaged and to grasp the material properly.

Goodman also laments the one-way nature of virtual classrooms.  Students and teachers don’t get to interact; students can’t get questions answered in real time.

“I can’t just read math and understand it. I need it taught to me so that I can fully understand it and grasp the material,” Goodman explained.

But at least Goodman’s classes take place during the day. Marta Ortega, a Saint Peter’s international student from Spain, does not have that luxury.

“I had to go back to Spain, so now I’m six hours ahead,” said Ortega, an international business major. “This makes it very complicated because one of my courses finishes at 3 a.m. I understand online courses are the only way to continue during this pandemic, but I strongly think it can be done differently.”

Saint Peter’s is not the only school that has been shut down due to COVID-19. On March 16, New Jersey Governor Phil Murphy ordered the closure of all public and private schools across the Garden State.

The way online classes are taught varies greatly, depending mostly on the professor. Some use online video chatting software such as Zoom or Google Hangouts, while others prefer to post assignments electronically.  Blackboard, a digital platform where professors can upload assignments, quizzes and discussion boards, is often used.

According to Goodman, three of his professors used Google Meet once but may not continue to use it all the time; a fourth professor posted a lesson using Microsoft PowerPoint; and yet another professor videotaped himself lecturing and uploaded that.

On March 25, Saint Peter’s extended its spring semester deadlines for dropping courses with no repercussions and for converting courses from letter grading to pass/fail. Kean University in Union, NJ went one step further: It decided to let students choose the pass/fail option on up to two courses after grades from all courses are posted the end of the semester. Kean’s administration decided this in response to a petition the students had circulated on Change.org that garnered over 3,000 signatures.

As Goodman finishes up his courses off campus, he hopes the coronavirus pandemic will show St. Peters’ administration that, as a matter of course, professors need to receive more training on using online resources so they’re better able to handle crises like the coronavirus pandemic in the future.

“A lot of [my professors] had to learn on their own how to fully use Blackboard, Google Meet and other platforms. I feel that this should be taught to all faculty members,” he said. “We need to be prepared for anything.”

 

Header: Photo by Alexandra Antonucci

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New Jersey Tax Filing Deadline is Extended from April 15th to July 15th

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The state income tax filing deadline and the corporation business tax filing deadline will be extended from April 15 to July 15, as part of the State’s response to the ongoing COVID-19 pandemic. This is an automatic extension. There is no need to file for an extension.

Governor Phil Murphy, Senate President Steve Sweeney and Assembly Speaker Craig Coughlin issued the following joint statement yesterday on the tax filing deadline and the state budget timetable:

“The ongoing COVID-19 pandemic has caused hardships, financial strain, and disruptions for many New Jerseyans and New Jersey businesses. As part of our response, we have reached agreement that the state income tax filing deadline and the corporation business tax filing deadline will be extended from April 15th to July 15th.

“Additionally, as part of the whole-of-government effort that is going into fighting COVID-19, we have agreed that the state fiscal year should be extended to September 30th . This will allow the Administration and the Legislature to focus fully on leading New Jersey out of this crisis, and to allow for a robust, comprehensive, and well-informed budget process later in the year.

“We are committed to working together to enact the necessary legislation and supplemental appropriations to accomplish these goals.”

Previously, the U.S. Treasury Department and Internal Revenue Service announced that the federal income tax filing due date is also extended from April 15 to July 15. Taxpayers can also defer federal income payments due on April 15, 2020 to July 15, 2020, without penalties and interest, regardless of the amount owed. This deferment applies to all taxpayers, including individuals, trusts and estates, corporations and other non-corporate tax filers as well as those who pay self-employment tax. Taxpayers do not need to file any additional forms or call the IRS to qualify for this automatic federal tax filing and payment relief.

 

Header:  Photo courtesy Governor Phil Murphy’s Facebook page

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Books to Read During the Pandemic

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“Reading is the sole means by which we slip, involuntarily, often helplessly, into another’s skin, another’s voice, another’s soul.” – Joyce Carol Oates

The prolific Jersey author might be onto something here. As Jersey City joins the viral effort of other municipalities across the country to defeat-by-retreat the coronavirus, more and more people will find themselves alone (or, in the current vernacular, “socially distanced”). But that doesn’t have to mean cutting oneself off from humanity. Books, as Oates eloquently notes, offer an opportunity for connection, for slipping into another skin or even another world — or for helping make better sense of one’s own.

The following titles, fiction and non-fiction, for adults and young readers might just help you thrive in the brave new world that’s currently causing all of us so much anxiety.

“A Game of Thrones” by George R.R. Martin. Want to escape into a rich, all-encompassing fantasy world? There’s no better place to lose oneself in than the dark magical world of George R.R. Martin (who hails from Bayonne, NJ). Although most people know of this work through the highly acclaimed HBO series, the book offers satisfactions (and complications) that the filmed shows for all their intrigue and brutality simply can’t match. There’s a reason this book won a bunch of literary awards and converted millions of readers (many of whom didn’t consider themselves fans of fantasy until they entered Martin’s world). And the good news is if the current restrictions on widespread social movement continue indefinitely, there are lots of follow-up volumes to this original work.

“Wherever You Go, There You Are” by Jon Kabat-Zinn. This is one of those rare self-help books that actually can really help you. Having sold almost a million copies since it was first published in 1994, this is the perfect book for these troubling times. Kabat-Zinn, a professor emeritus of medicine at the University of Massachusetts, offers his plan for improving “mindfulness” through meditation. But as he’s quick to point out, meditation is not some weird cryptic activity (his words) but a scientifically established practice that can help reduce stress, improve cognitive function, and lead to greater awareness. The exercises he offers in the book can be done by anyone, anywhere, at any time. You could do worse than to turn from the news of the world to the world inside of you and discover something new and something calming.

 

“Pale Rider” by Laura Spinney. It might seem counter-intuitive to try to take your mind off the current global virus by reading about a previous global virus, but science journalist Spinney details like a novelist the grim and gripping story of the 1918 flu pandemic (known colloquially as the Spanish Flu) that killed 50 million people worldwide. Her account of the lives touched and taken by the H1N1 virus (the same strain of flu that circulated a decade ago in a world much better prepared to deal with it) is sobering but riveting. For those feeling helpless in the current situation, reading Spinney will remind you of just how much more adept global society has become in diagnosing and dealing with pandemics no matter how dire things seem when you turn on CNN.

“Americanah” by Chimamanda Ngozi Adichie. If the coronavirus has reminded us of anything, it’s that we’re all connected globally. Americanah, winner of the National Book Critics Circle Award for fiction, tells the story of two Nigerians, young and in love, whose hopes and desires lead them to take divergent paths to the United States and the U.K. They reunite years later in newly democratic Nigeria where they reckon with their respective pasts and reignite their earlier passion. There are epic, timeless elements to the tale as well as contemporary scourges like post-9/11 xenophobia and the indignity of being an “undocumented” person. It’s a book about what we give up to gain what we thought we always wanted; in our current cloistered climate of confinement, it asks us to re-examine what it means to be free.

“Alice in Wonderland” by Lewis Carroll. Think you know the story? Read it again. Alice’s trip down the rabbit hole is the perfect tale for these uncertain times. Is it a metaphor for what happens when we lose control of our landscape? Is it a cautionary tale about how treacherous life is when previously established social controls are loosened? Is it a call to put anxieties aside and embrace the strangeness of the human experience? Is it a celebration of the diversity of our planet, a diversity we take for granted until we’re forced to see it through the eyes of our fellow inhabitants? It is in equal measure silly and surreal, terrifying and teasing, humorous and harrowing. And its mesmerizing cast of characters is as memorable as any to be found in Western fiction. Plus, your kids will love it.

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New Jersey’s Nurses Mobilize in War Against COVID-19

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Active nurses, student nurses and retired nurses — including a state assemblywoman — are volunteering to go where needed, from critical care to pop-up hospitals

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.

Full story link – HERE.

By Ian T. Shearn

Before COVID-19 reached New Jersey, Holy Name Medical Center in Teaneck had a 19-bed intensive care unit and 33 critical-care nurses. Now it has added four ICUs and is treating 45 patients, 40 of them on respirators. To satisfy the growing demand, about a dozen nurses have been reassigned from other units that have been temporarily closed, and a handful have been hired.

Bergen County, particularly Teaneck, is the coronavirus epicenter in New Jersey. On Tuesday, the number of COVID-19 patients at Holy Name reached 151. Thus far, 25 patients have died. Nurses there are running in a triage marathon, a race in which no one can see the finish line.

“They’re holding up … Morale is good,” said Michele Acito, Holy Name’s nursing director. “Every single nurse has risen to the occasion, and beyond. They are amazing. It’s a crisis none of us have ever seen.”

Nurses — a proxy of hope

Photo by Jeff Rhode / Holy Name Medical Center

Critical-care nurses are a special breed. Their job requires a highly specialized skill set and an extraordinary emotional IQ. Candor and compassion. In addition to administering meds and operating a variety of complex medical devices, they are the patient’s only connection to their family. At Holy Name, nurses keep the family informed by phone, and also connect them with the patients via iPad. In the course of their duties, the nurses supply their patients with medical information, small talk, encouragement and solace. In short, they are the patient’s proxy of hope.

As for their inventory of personal protection equipment (PPE) — N95 masks, gloves, gowns and face shields. “We’re doing OK. We’re good for at least a couple of days,” Acito said. And they have been able to acquire enough ventilators — at least for now. “ Our materials guy has worked magic.”

There has been a taxing nursing shortage in New Jersey for many years, primarily because an aging population is creating more need for medical care. And with nursing schools unable to keep up with the number of retiring baby boomers, the problem gets more serious. Add a pandemic, with the number of the infected still spiking and four field hospitals being rapidly built, and you have a crisis.

On Friday, Gov. Phil Murphy issued an unprecedented plea for medical volunteers. The response was swift and remarkable: As of Monday, 4,764 responded to the call. Nearly half were nurses, many responding to a call for help from the New Jersey State Nurses Association. This is the breakdown of that response, as of Tuesday:

  • 1,425 nurses with active licenses
  • 520 student nurses
  • 125 retired nurses

State Assemblywoman Nancy Munoz, a retired critical-care nurse, photo courtesy Nancy Munoz Twitter

State Assemblywoman Nancy Munoz (R-Union) was one of them. She is a retired critical-care RN.

Two weeks ago, she was driving in her car, listening to New York City Mayor Bill de Blasio on the radio making a public plea for more medical staff. That prompted her contacts in the governor’s office to see what New Jersey was doing on this front. She soon hooked up with the Union County Emergency Corp, signed up to volunteer and promptly found herself swabbing people Saturday at a COVID drive-up testing site at Kean University.

“I didn’t hesitate” to volunteer, she said. “I am not sleeping well. I’m tossing and turning. All I can think about is what can I do?”

Munoz retired from nursing in 2002, after a 30-year career as a critical-care surgical nurse with a master’s degree in adult primary care.

At Kean, she joined about 30 other volunteers, including nurses, pharmacists and the National Guard. Outfitted in double hair nets, double faces masks, triple gloves and a plastic shield, she and her colleagues took samples from hundreds of people in makeshift tents.

Because of her training and protective gear, she had no fear, but “some of the people were terrified. A 6-year-old boy was crying. We reassured all of them,” she said.

At the end of the day, she returned to her Summit home, through the basement, where she put all of her clothes in the laundry and then showered. She said she plans to return to Kean and offer more help this week. In the meantime, she’s making surgical masks on her home sewing machine.

As of Saturday, Hackensack Meridian, the state’s largest health care provider, had 1,400 COVID-19 patients at its hospitals, according to CEO Robert Garrett. A third of them are in ICU and more than 300 are on ventilators. Garrett said Health Commissioner Judith Persichilli has instructed all hospitals to prepare to double their ICU capacity in the next three to six weeks.

The number of infected people in New Jersey is doubling every six days. If things continue unchanged, New Jersey will run out of ICU beds to care for coronavirus patients within the next two weeks, Murphy said Monday.

“We have enacted several practices to concentrate staff in our emergency departments and ICUs as this pandemic continues,” said Dr. Daniel W. Varga, chief physician executive at Hackensack Meridian. “For example, we postponed elective surgeries, which is increasing capacity by 20% and permitting us to redeploy nurses. Our administrative teams are also hiring more per diem staff and inviting retired clinical personnel to return to aid in treating our patients.”

Getting rid of red tape

To accommodate reinforcements, the state has also waived a host of regulatory requirements to allow out-of-state and retired nurses, doctors and other medical professionals help. The Department of Consumer Affairs intends to grant applications within hours of receiving the form. The waivers also will facilitate the work of health care staff of the National Guard who have been deployed in New Jersey to assist with the response to COVID-19.

As of Tuesday, the DCA had licensed an additional 674 nurses, who can now report to work. That brings the total number of licensed nurses in New Jersey to 170,728.

Nurse takes temperature of visitor at Christ Hospital, photo by Jennifer Brown/City of Jersey City

Persichilli has also signed a directive that permits hospitals to use advanced practice nurses, paramedics and physicians assistants to care for patients in noncritical areas, so that the intensive-care doctors, pulmonologists and critical-care nurses can stay at hospitals to care for the most severely ill COVID-19 patients. And Murphy also authorized the immediate payment of more than $140 million to health care providers to prepare them for COVID-19-related expenses, including expanding capacity.

To monitor the pending crisis, the state’s 71 acute care hospitals have been ordered to provide the DOH daily reports on bed space, staffing levels, ventilators and PPE stocks. The state is working to add bed space — reopening one closed hospital and setting up three temporary facilities  — and seeking to amass more PPE and ventilators from closed surgery centers and a federal stockpile.

Rutgers New Jersey Medical School in Newark announced over the weekend it would expedite the graduation of about 200 students who will then be eligible to begin their residencies to help out state hospitals. Students would normally have completed their required courses in April and graduated in May, but now the 192 students will graduate between April 10 and April 21.

Officials are also turning to the private sector to help them find nurses — to people like Paul Ruderman, CEO of All American Healthcare, a health care staffing agency in Newark specializing in temporary employment for nursing personnel.

“Pre-COVID, the demand was tremendous. Now it’s through the roof,” says Ruderman, who continues to hire additional internal, administrative and operational staff to keep up with the ever-increasing demand for nursing personnel, particularly during the crisis.

Ruderman said he has also been asked by the health department to help recruit nursing personnel for several of the pop-up field hospitals that are opening across the state. The response from nurses and others has been overwhelming, he says, with more than a thousand nurses and nurse assistants ready to deploy in the coming weeks.

The Rutgers University School of Nursing in New Brunswick is also recruiting contract RNs for intensive-care units and emergency rooms. A posting on the school’s website reads: “We have immediate contracts of 8-13 weeks in duration at a compensation at $90/hr … The schedule includes 12-hour day and night shifts, 4-days a week. The positions also qualify for overtime (OT) pay.”

Not enough gear to go around

For some, more troubling than the staffing shortages is the critical shortage of equipment — ventilators, N95 masks and gowns.

Photo by Jeff Rhode / Holy Name Medical Center

“There’s just not enough,” says Doug A. Placa, executive director of JNESO District Council 1 IUOE-AFL-CIO, a labor union that represents professional 5,000 health care workers, mostly nurses, in New Jersey and Pennsylvania. “We’ve been working with the governor’s office to rattle some cages in the federal government to get supplies to frontline workers. And we mean now.”

 “Do we have enough PPE? The answer is “no,” and we know that,” Persichilli said. “We haven’t had enough PPE for a long time, and I know that the workforce perspective, that’s the thing that is concerning them the most.”

After the governor closed all state universities last month, Rutgers University School of Nursing Dean Donna Nickitas had to put all of the school’s classes online for home instruction. She also decided to cancel all practicums, or onsite clinical placements, needed for graduation.

“I had to do it for their safety,” Nickitas said. “They just weren’t fully prepared” for the sudden dangers that would face them. Instead, students are now satisfying the practicum requirements with an interactive software platform that offers a virtual clinical experience in a simulated patient room.

Hurry up and wait for one ‘near nurse’

Meanwhile, Jessica Dybus, a 24-year-old from Williamstown, is sitting on her hands.

On Jan. 16, she attended her pinning ceremony as a graduate of the Rutgers-Camden nursing school, eager to launch her career. At that time COVID-19 was barely on her radar. She had heard reports about it in China, but she, like most of America, had no idea what was in store. She assumed she would be working in the field in a couple of months.

But the day before she was scheduled to take her licensure exam in March, she received an email, informing her it had been cancelled because of the pandemic. Now, she is hoping to take it in May, but that remains uncertain.

“It’s awful,” says Dybus, whose mother is a nurse. “I want to be out there helping people.”

Dybus is an EMT and has experience in ER and trauma. She plans to become a doctor. “This is my dream,’ she says. But she’s ready to work right now, and if they put her in an ICU with COVID-19 patients, that’s fine. “Wherever I can help,” she says.

 

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Jersey City Hospitals Adopt New Triage Protocols for Pandemic

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Jersey City Medical Center has created a new protocol and an expanded locale for its emergency department in response to the coronavirus pandemic sweeping the city and the country. Earlier this month, Jersey City Mayor Steven Fulop joined Christ Hospital administrators in announcing a new screening system designed to safeguard health care staff and patients during the crisis as well.

Both hospitals have set up pre-screening tents outdoors, outside their emergency departments, a sign of just how busy the institutions have become. That is where the protocols at the two facilities diverge slightly. At the medical center, individuals who present with severe symptoms of COVID-19 “will be transported directly to the ED (emergency department) for a more comprehensive evaluation, care, and isolation.  Others will be directed to a mobile satellite emergency department on site,” said Michael Loftus, MD, chief medical officer, Jersey City Medical Center- RWJBarnabas Health.

“For non-COVID-19 related urgent or emergent care, patients will be directed or shuttled to a new urgent care directly across from the hospital at Colony Plaza, 414 Grand Street,” Loftus continued. “This is not a COVID-19 testing site but will care for non-COVID emergent and urgent patients during the ongoing pandemic,” he explained.

Christ Hospital is also separating those with non-coronavirus-related emergencies from those with symptoms of COVID-19, such as fever, cough or flu-like symptoms — or any combination of thereof. But it is sending the former to its existing emergency room for appropriate treatment whereas persons who present with at least one COVID-19 symptom are themselves bifurcated: Those who hospital staff determine can safely recover at home are treated and released; those determined to need admitting are directed to beds dedicated to Covid-19 patients that are spread among three floors of the hospital, according to Dr. Tucker Woods, Christ Hospital’s chief medical officer.

Triage at Christ Hospital, photo courtesy Dr. Tucker Woods

As of last week, Christ Hospital was caring for 50 persons diagnosed as coronavirus patients, according to Woods. All are elderly, and the majority are male.

Since the hospital began admitting coronavirus patients, there have been “expirations,” Woods went on to say — though he declined to say how many. Equally vague was Woods regarding the number of infections amongst the hospital’s staff. While Woods did note that, in epidemics, it’s not unusual for personnel infection rates to approach 35 percent, in discussing Christ Hospital’s own employees having the coronavirus, the chief medical officer said simply “Not so many here.”

Woods said the hospital’s health care staff is doing the best it can to cope with limited amounts of personal protective equipment.

“We don’t have enough sanitizing wipes for disinfecting mattresses, so we’re using bleach, which is not ideal” he said. As of last week, other items needing replenishment were hospital gloves, swabs used to check for the virus and ventilators, he said.

Woods credited New Jersey Health Commissioner Judith Persichilli, R.N., with quickly arranging for a March 24 delivery of five ventilators that were urgently needed. Prior to their delivery, the facility was using 14 of its 16 units (and prior to that, before coronoavirus’s becoming a household word, Christ maintained three to six ventilators at any one point in time, according to Woods).

What’s to come?

“In early March the (ER) numbers were off the charts,” Woods said. “We were 40 percent busier than usual. Many of the admissions were for flu-like symptoms, but after the news of the pandemic hit, the numbers took a nosedive down,” he said.

Still, Woods remains cautious. “I think it hasn’t peaked yet,” he said. “I think it will get worse and eventually plateau. We’re doing the best we can to contain it.”

Woods credited the hospital’s housekeepers and health care professionals on the front line with bearing the load. He also thanked the community at large for their donations of medical supplies and food for staff.

Triage at Christ Hospital, photo courtesy Dr. Tucker Woods

Header: Nurse takes temperature of visitor at Christ Hospital, photo by Jennifer Brown/City of Jersey City 

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Hudson County Partners to a Create a Stepdown Unit for Recovering COVID-19 Homeless Patients

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Unit will provide relief to county hospitals so they remain focused on critical care and homeless shelters to lessen spread of the disease in vulnerable populations

Hudson County announced today that it has entered into a partnership with CarePoint Health and Alliance Community Health, a Federally Qualified Health Care Provider (FQHP), to create a step-down unit for recovering COVID-19 patients who are homeless in two currently unoccupied buildings near Christ Hospital in Jersey City, (169 Palisade Avenue) by the end of this week.

The purpose of the unit is to allow hospitals in Hudson County to discharge patients who initially tested positive for COVID-19 and were admitted but now are deemed fit enough for discharge but who are homeless.

Hospitals can only release patients who can demonstrate they have somewhere to go upon discharge. Having homeless shelters provide this for the recovering patient now would expose vulnerable populations with chronic health issues in the shelters to these still recovering individuals who could transmit the virus to them.

This new unit will help ensure that the health care system remains focused on critical care and able to provide the beds required for that mission and protect the shelter network from the spread of the virus.

The target population is homeless individuals demonstrating mild symptoms, who if they had stable housing would simply be released to recover at home.

The Hudson County Improvement Authority (HCIA) will lease the space from CarePoint Health to set up what is known as a Federally Qualified Healthcare Center (FQHC) for the County in partnership with Jersey City-based Alliance Community Health,Inc., in order to provide this step-down unit for an anticipated 100 homeless clients at one time.

The HCIA will be reimbursed by the County Division of Welfare at the rate Welfare pays for shelter services provided by local hotels and motels with funds provided by the State Department of Family Development during this pandemic. The initial estimated cost to operate the unit will be $296,000 a month.

The step down unit for the recovering homeless will provide the following services to these recovering homeless individuals:

  1. 24-hour access to clinical care through a staff of doctors and nurses.
  2. Regular monitoring of inhabitants respiratory function.
  3. Monitor for potential relapse so a proactive decision can be made to re-admit a person into the hospital.
  4. Medically clear those in the homeless shelter population in isolation so that they can enter shelters again without concern that they might infect anyone in the shelter network, staff, volunteers, vulnerable fellow clients.
  5. Professional medical laundry and cleaning services, and medical waste disposal services.

A contractor that provides security at medical facilities in the region will do so for this new unit.

“I believe this is a sensible way to ensure that our hospitals can focus on providing critical care and our homeless shelters remain truly safe havens for those in need of them,” said Hudson County Executive Tom DeGise. “I want to thank the leadership of CarePoint Health, the City of Jersey City and our dedicated team from the Hudson County Department of Family Services and the HCIA who put this together.This unit will help stop the spread of COVID-19. It will save lives.”

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