State Deploys COVID-19 Saliva Test at Centers for Developmentally Disabled, Some Nursing Homes

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By Lilo H. Stainton, NJ Spotlight

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

New Jersey plans to use a new, easier-to-administer COVID-19 test to screen residents and staff at state-run facilities for individuals with significant developmental disabilities and at nursing homes in South Jersey, strategy officials said could serve as a model for more widespread public testing as the state tries to recover from the coronavirus.

The initiative — the state’s first foray into large-scale institutional testing — will focus first on the 1,238 residents and roughly 4,300 employees at New Jersey’s five developmental centers; nearly 250 people living or working at these sites have been diagnosed with COVID-19, and seven residents have died of the disease.

State officials said they are also working with leaders at Cooper University Health Care, in Camden, to create a testing program for residents and staff at 16 long-term care facilities in the region; the goal is to use this screening to help contain the spread of the virus in a region that has so far been spared the worst of the outbreak. Across the state, nearly 13,800 positive COVID-19 tests have been connected to nursing homes and other residential care sites, and at least 1,540 deaths have been reported, with the worst impact at facilities in North Jersey.

Another 24,000 individuals with disabilities live at group homes in the community operated by state contractors; among this group, 221 have tested positive for the viral infection and 26 have died, according to the latest statistics. These facilities are not part of the initial saliva-testing program, but state officials said they intend to use this method to screen additional state workers and individuals in institutional care, so they could be among those on the list for this approach.

‘Prioritizing vulnerable populations’

“As we work to expand testing across the state, we will be prioritizing the most vulnerable populations like those who reside in these centers,” state Health Commissioner Judith Persichilli said. Residents in more crowded institutional settings, where it is hard to maintain social distance, are particularly at risk for becoming infected.

“Human Services is continuing to work 24/7 to support and protect individuals with developmental disabilities across our state,” said Human Services Commissioner Carole Johnson, whose department oversees programs for developmentally disabled residents. “The Department will continue to take all available actions to support our residents and staff.”

The state has faced a growing backlash for its efforts to control the spread in some public institutions, like veterans’ homes and prisons, where the virus has exploded in recent weeks. As of Monday, more than 500 corrections officials and inmates were infected and 16 prisoners had died. A plan to release certain nonviolent inmates has been slow to take effect after Gov. Phil Murphy announced it earlier this month.

Officials said the saliva test, unveiled by Rutgers University earlier this month, is already in use at multiple public screening sites, including the Federal Emergency Management Agency’s operation in Edison. Starting today, it will be also be offered at Robert Wood Johnson University Hospital in New Brunswick to screen all health care workers, whether or not they have symptoms; it is also being shared with other hospitals and health care networks, they said.

Murphy to discuss wider public use 

Murphy said he anticipates this type of testing will also be useful for wider public application, a process he promised to flesh out on Monday. “I have noted many times having a robust and greatly expanded testing program in place is vital to our being able to reopen responsibly our state,” the governor said at his press briefing Thursday. “I said it on Monday and I still believe it on Thursday that we need to at least roughly double our testing capacity’s minimal benchmark” to allow for a safe return to public life, he added.

New Jersey is now able to process tests for between 7,000 and 9,000 people daily between the public and commercial laboratories, according to state health officials; this number is impacted by the availability of test kits, swabs and other materials needed to administer the test, trained staff and the personal protective equipment (PPE) — gowns, masks and other health care gear — needed to keep them safe. Overall, nearly 100,000 residents have been diagnosed with the virus, including more than 5,300 who have died.

Dr. Brian Strom, chancellor of Rutgers University Biomedical and Health Sciences  — an umbrella entity that oversees the program that developed the test in conjunction with a private lab — said the new method has the capacity to screen 10,000 people a day and could be scaled to two or three times that volume fairly easily; they are currently seeking the staff and other resources needed to make this expansion possible. The process includes collecting a small amount of saliva in a special tube, which he said is far easier, and less invasive, than the deep nasal and throat swabs needed for the traditional test. It also appears to be more accurate, according to a new review by Yale University, he said.

Collecting the saliva sample also involves far fewer clinicians than the previous tests, Strom noted, a benefit that reduces the need for PPE by 90% and doesn’t depend on swabs, which have been in short supply. An easier collection process also speeds the testing protocol, allowing four times as many people to be screened than under the swab system, he noted.

Strom said these characteristics make the saliva test ideal for widespread public use. Rutgers is now working with Newark Mayor Ras Baraka to design a program to screen at least 100,000 Brick City residents, he noted, and the university also plans to use the test to help assess the health of students and staff as it decides how to reopen classes.

Key for health care providers

The test will also be important for health care providers as they continue to respond to the current epidemic and plan for what’s next, Strom said. “As we begin to plan for the ability of the health care enterprise to begin to take care of non-COVID patients again we need to be sure we don’t give COVID to the patients we take care of,” he noted.

While Murphy has repeatedly cautioned against relaxing the strict social-distancing requirements instituted in late March, he has also hinted for weeks at the need to plan the state’s reopening, or re-entry, and coordinate the timeline with other states in the region. On Sunday, he appointed his chief of staff, George Helmy; Robert Wood Johnson Foundation President and CEO Dr. Richard Besser; and former U.S. Secretary of Homeland Security Jeh Johnson to a multistate council that will oversee this process.

Murphy has also stressed that reopening the state requires not just a robust testing program, but also the capacity to track down and warn all the potential contacts for someone who tests positive, and the ability to quarantine that person — providing shelter, food, medicine, and other services — for up to 14 days. Persichilli said she is finalizing a testing strategy required for a larger, statewide reopening, which she said would be available next week.