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Daniel Levin

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

April 3, 2020/in header, Latest News, News /by Daniel Levin

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.

Daniel Levin

NJ Outlines Field Hospital Plan to Prepare for Surge of COVID-19 Patients

March 26, 2020/in header, Latest News, News /by Daniel Levin

NJ Outlines Field Hospital Plan to Prepare for Surge of COVID-19 Patients

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

New Jersey Gov. Phil Murphy pledged Wednesday to spare no expense in saving lives from the coronavirus and promised to leave no patients “on the battlefield” in the state’s fight to win the war on the pandemic.

Critical to the state’s response are the four temporary “field hospitals” being planned by U.S. Army officials, the first of which Murphy said would be open within a week at the Meadowlands convention center in Secaucus. Three other units will follow within roughly a month, he added, with two located at the massive convention complex in Edison and another at the Atlantic City Convention Center. Each will have roughly 250 beds.

While some hospitals — especially in hard-hit Bergen County — have reported being inundated, Murphy said most of the state’s acute-care facilities are “currently meeting the needs” of patients diagnosed with COVID-19 or other medical conditions. Nearly 4,500 New Jersey residents have now tested positive for the disease caused by the novel coronavirus and 62 have died.

Making more beds available

But with COVID-19 diagnoses growing daily — a result of both wider testing and the disease’s spread — state health officials want to add some 2,360 hospital beds in the coming weeks. Reopening hospitals or hospital wings that were recently closed will satisfy just over half this need, they estimate, and the field hospitals should add another 1,000 beds.

“We must be ready for the time when the surge comes” and the state’s existing 72 acute-care hospitals can no longer accommodate those who need treatment, Murphy said at his daily media briefing Wednesday. “We have been working rapidly to expand hospital capacity. Make no mistake, we are in this fight to save lives.”

“We will leave nothing on the battlefield in that effort. There is no cost too high to save one precious life,” the governor continued, recounting how in the United States, soldiers are trained to never abandon their fellow fighters in war. “That is America. And that is New Jersey. We will fight to save every single life,” Murphy said.

New Jersey — where the positive COVID-19 case count has grown by as much as one-third overnight — has instituted strict social-distancing measures to reduce contact among residents and slow the spread of the disease to reduce the impact on health care. Murphy has required hospitals to cancel elective surgeries and public health officials have encouraged individuals with mild symptoms to avoid visiting the doctor or local emergency room to further spare the medical system.

U.S. Army Corps to the rescue

The field hospitals will be set up by the U.S. Army Corps of Engineers, which has a long history of creating pop-up medical facilities in times of public-health disaster or war. The Corps is also working with New York State to retrofit the enormous Javits Center convention space in New York City so it can host hospital overflow; it has templates for space configuration, security and operations guidelines, work orders and more on its website.

“We will not be left scrambling. We will be ready to act decisively to protect our residents,” Murphy said. “We hope this all remains measures of preparedness,” he added, saying no one would be happier than he would if it turns out New Jersey doesn’t need the extra hospital capacity.

Nurse Suzanne Willard, associate dean for global health and a professor at Rutgers School of Nursing, said that the U.S. military has vast experience worldwide in quickly creating these facilities to care for victims of war, natural disasters or pandemics.

“They are well attuned to setting these up,” Willard said. “And things need to move rapidly,” she added, noting that while China was able to build new, permanent hospitals in several weeks to treat COVID-19 patients, that would be near impossible in this country.

Existing Garden State hospitals provide nearly 23,000 beds in total, including nearly 2,000 designated for critical care — considered vitally important for patients with serious respiratory issues. COVID-19 can cause mild cold-like symptoms and fever in most healthy people but can be deadly to older individuals or those with underlying conditions like diabetes or heart disease.

While the state does not have an automated system to monitor hospital bed availability in real time — or track the number of COVID-19 patients now getting treatment (either inpatient or outpatient) — State Department of Health Commissioner Judith Persichilli is working with experts to model the surge and its impact on individual hospitals. A separate study, by Rutgers University Camden, suggests the need could top 122,000 beds at some point, even with strict social-distancing measures.

Keeping an eye on COVID-19 in NYC

Persichilli is also closely watching the progress in New York State — now the national epicenter for the outbreak — where Gov. Andrew Cuomo said the case load is expected to peak in two or three weeks. “The algorithms are good, but the boots on the ground are what we are monitoring carefully,” she said Wednesday. “When we see this peak in New York, I think we can expect Bergen, Essex and Hudson (counties) will follow this trend.”

Bed space is only one worry, as Persichilli has made clear. Doctors, nurses and other staff are already in short supply — a growing concern as more caregivers are infected with COVID-19 — and stocks of masks, gowns and other protective items are dwindling fast, health care providers warn. The state is also short at least 300 ventilators, Persichilli said.

On Tuesday, Persichilli indicated that health officials have identified the staff needs for the field hospitals and are working with professional organizations to draft the clinicians needed. The state also plans to use nursing students in their final semester and may contract with a staffing agency for additional workers.

The hope is to coordinate both staffing and medical supplies — for the field hospitals and other COVID-19 response efforts — through central, government-run programs that can track and distribute resources statewide. Murphy said New Jersey has received some — but not nearly all — of the supplies it has requested from a federal stockpile. It is also collecting donations of medical equipment from corporate partners, closed ambulatory surgery centers and members of the public.

Persichilli said she is working closely with the New Jersey Hospital Association to coordinate a plan for these temporary facilities, which will be used for patients with less serious medical needs — regardless of their diagnoses. As demand for critical-care beds rises, so-called step-down rooms will be upgraded to also handle severe cases, and patients from these units will be moved to beds traditionally used for patients with limited medical needs.

The commissioner said this approach allows hospitals to serve as larger, critical-care complexes; some have offered to transfer out certain patients and exclusively treat individuals with COVID-19. The field hospitals will provide for those with COVID-19 and other conditions that require less medical intervention. The three regional Level 1 Trauma Centers will coordinate patient assignments at each field site, she said.

“We’ve looked at the whole continuum, and the hospitals are right now aggressively opening up every single bed that they have,” Persichilli said Tuesday.

While it is not yet clear exactly what treatments the state’s field hospitals will be able to provide, Rutgers’ Willard said these facilities can be outfitted to handle everything from basic to more critical care, or even surgery. But they are often used to triage people with certain symptoms and provide essential clinical support, like oxygen and fluids, in an effort to stabilize patients and prevent them from requiring more intensive treatment.

“This is really a time for mitigation,” Willard said, “to keep the bulk of the population in the state healthy and to isolate those who have the virus and also be able to provide care” for patients who need hospital treatment. “If you’re not treating people, they’re going to get sick and die on you,” she said.

News Briefs

Mayor Fulop and Via,  announced the expansion to weekend service of Via’s on-demand publicly subsidized transit system.

A GoFundMe page has been created here for Christian Parra, age 34, of Jersey City, who was shot on Sunday night in BJ’s parking lot on Marin Boulevard and Second Street. He left a wife and three children. Anyone with information is asked to contact the Office of the Hudson County Prosecutor at 201-915-1345 or to leave an anonymous tip here. 

Jesus Gonzalez, 30, died in a car crash on Saturday night when the car in which he was a passenger hit the attenuator-protected guard rail on Christopher Columbus Drive near Merseles Street. The driver, also 30, was listed in critical condition at Jersey City Medical Center.

The Jersey City Education Association has started a GoFundMe campaign to support the family of 11-year-old Desire Reid and eight-month old Kenyon Robinson who died in a house fire on Martin Luther King Drive on Wednesday night. Here is the link.

Vaccine-eligible individuals can make an appointment online by visiting hudsoncovidvax.org.

The 2021 tree planting applications are available. If you have an empty tree pit on your block or a street you can fill out the form and the city’s arborists will handle it.  bit.ly/adoptatreespri…

Keep abreast of Jersey City Covid-19 statistics here.

Governor Murphy has launched a “Covid Transparency Website” where New Jerseyans can track state expenditures related to Covid.  Go here.

For info on vaccinations, call Vaccination Call Center and our operators will assist you with scheduling one: 855-568-0545

 

 

 

 

 

 

 

 

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