MORRIS COUNTY — Representative Mikie Sherrill (NJ-11) will hold a second COVID-19 telephone town hall focused on small business and unemployment assistance on Tuesday, April 7. Representative Sherrill will be joined by public officials who will help answer questions from residents and she will give an update on what she has been doing to support COVID-19 response efforts in New Jersey.

“Every day, I am on the phone with our small businesses, local officials, and residents in North Jersey, and I know the incredible strain they face as we fight the COVID-19 crisis,” said Representative Sherrill. “Our town hall this week will focus on the resources available to small businesses and workers at the federal and state level. We had an overwhelming response to our last telephone town hall, and I hope residents join us again on Tuesday.”

Residents are invited to register for the telephone town hall by clicking here.

WHAT: Telephone Town Hall on Small Business and Unemployment Assistance

WHO: Representative Mikie Sherrill

WHEN: Tuesday, April 7, 2020 at 4:50 p.m. EST

WHERE: Residents can register for the Telephone Town Hall by clicking here.

MORRIS COUNTY — Governor Phil Murphy has exempted blood drives from his Executive Order that prohibits public gatherings to allow for blood donations to meet the medical needs of New Jersey residents during the COVID-19 crisis.

Blood drives may to operate but only using appropriate mitigation efforts to prevent the spread of COVID-19. That would include incorporating social distancing where practicable, collecting blood only from individuals who are healthy and feeling well, conducting temperature screens of both staff and donors before entering a blood drive

It also would require the use of personal protective equipment (PPE), providing hand sanitizer to donors, and frequently sanitizing equipment and work spaces

The American Red Cross, meanwhile, has put out a call for blood donations to ensure an available blood supply for hospital patients. It is strongly urging eligible donors to schedule their next appointment to donate blood at a blood drive scheduled near where you live or work.

The Red Cross says donating blood is a safe process and asks healthy residents to donate soon.

Schedule your appointment now!

PARSIPPANY — Representative Mikie Sherrill (NJ-11) released the following statement on her family testing positive for COVID-19:

“This week, my husband was tested and diagnosed with COVID-19. After developing symptoms myself, and speaking to my doctor, I have scheduled a test.

“My work on behalf of our district, the fight to protect and provide our doctors, nurses, and first responders with critical personal protective equipment, and my commitment to deliver relief for our workers and small businesses remains my top priority.

“I cannot stress enough how important it is that we all follow the recommendations of the CDC and the ‘stay at home’ order that is in place. The road ahead for New Jersey is going to be a hard one, so now more than ever, we must take care of each other and work together so that we can end this crisis.”

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

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.

“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.

by Andrew S. Lewis, 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

Gov. Phil Murphy has called New Jersey’s lack of ventilators “dire,” and has increasingly called on the White House to deliver more from the federal stockpile. Why are there so few ventilators, and why are they key in the fight against COVID-19?

Does New Jersey have enough ventilators?

Murphy has requested 2,500 from the Strategic National Stockpile (SNS), a federal repository of pharmaceuticals and medical equipment that itself is now facing a shortage of masks, gowns, and especially ventilators as cases of COVID-19 soar across the United States.

As of Thursday morning, the state had received 850 from the stockpile. The governor has reiterated that he is still pressing for the outstanding 1,650 from the federal government. “That’s not theoretical,” he said. “We need them.”

Already, some New Jersey hospitals are nearing, or have hit, full ventilator capacity. And without a sufficient, centralized stockpile, states are now locked in a bidding war against each other and the Federal Emergency Management Agency for new Chinese-made ventilators. “It’s like being on eBay with fifty states, bidding on a ventilator,” New York Gov. Andrew Cuomo said in his daily briefing on Tuesday. “And now FEMA is bidding on top of the fifty, so FEMA is driving up the price. What sense does this make?”

In all the uncertainty surrounding effective treatment of COVID-19, there is one thing doctors and health care workers on the front lines are confident of: A mechanical ventilator will prolong the life of many infected patients, and oftentimes is the difference between survival and death.

Why does COVID-19 require mechanical ventilation?

 COVID-19 causes the respiratory tree of the lungs to become infected then inflamed, which in the most severe cases causes pneumonia and requires ventilation. Unfortunately, the severe pneumonia caused by COVID-19 is itself different from the more common, bacterial forms of the lung infection.

“In the setting of bacterial pneumonia, you give antibiotics to kill the bacteria,” said Dr. Andrew R. Berman, the Division Director of Pulmonary/Critical Care Medicine at University Hospital in Newark. “The problem with the COVID-19 virus is that there’s nothing really to give [patients].”

The combination of the infection and inflammation results in Acute Respiratory Distress Syndrome, an often fatal complication. “The COVID-19 virus is a problem,” Dr. Berman continued. “But the resultant inflammation is really where these patients end up requiring — and sometimes not necessarily responding to — the mechanical ventilation.”

What is a ventilator and how does it work?

“Ventilators are life support for the lungs,” Dr. Berman, who also serves on the American Lung Association’s New Jersey Leadership Board, said. Simply put, a ventilator is a machine that helps a patient breathe when they are unable to do so on their own.

A patient is sedated and intubated, a highly uncomfortable procedure that involves running a tube into the mouth or nose, and down into the windpipe. The tube is connected to the ventilator, which is then calibrated to deliver, or pump, air into the patient’s lungs that ranges from 21% oxygen content — “room air,” as Dr. Berman called it — all the way up to 100%, depending on the severity of the patient’s condition.

But the machines, which cost about $25,000 each (New York Gov. Andrew Cuomo said on Monday the price has now increased to “over $50,000” because of the bidding war), do much more than pump air into the lungs; in addition to precise percentages of oxygen, they deliver specific flows, volumes and pressures of air, as well as perform constant digital analysis.

Such complexity requires a team of highly skilled operators in the critical-care unit, keeping a round-the-clock watch over a patient whose condition, and oxygen need, is constantly changing. In general, a team of two specialists needs to be on-hand to keep a patient properly ventilated — a respiratory technician, who sets up and troubleshoots the ventilator, and a physician, who oversees the process. The ventilator’s computer then provides digital readouts of each tweak to oxygen, volume and pressure. “It’s a dynamic situation that’s frequently changing,” Dr. Berman said.

How many ventilators will New Jersey need?

In New Jersey there are approximately 2,000 critical-care beds most of which are ventilator-equipped, but the state has projected that it will need to double that number. In order to do that, the state is moving to make room for hundreds more by opening shuttered hospital wings, reopening at least one closed hospital, and building three temporary facilities.

State health officials have said about half the COVID-19 patients now in critical-care beds currently require ventilation, but they fear the need will rise and want every critical-care slot to have this capacity.

Since the federal government has delivered just 850 ventilators, the state is continuing to work on its own to acquire more, in case the outstanding SNS order falls through. “We have not been able to get a non-federal source for acquisition for ventilators successfully,” Murphy said in his Wednesday briefing.

At this point, it’s impossible to know exactly how great New Jersey’s ventilator shortage could become, if at all. Based on the projections for the spread of COVID-19 in New Jersey, Judith Persichilli, the Department of Health Commissioner, said in Wednesday’s briefing by state officials that, with the amount of ventilators the state received from the SNS, “we do believe we’re going to be okay, but we do believe we’re going to be moving ventilators around, from the south to the north, across regions.”

Before the pandemic, the SNS had a total of about 16,600 ventilators — 7,000 have since been distributed nationwide — though a portion of them are not working or require some maintenance and cannot be immediately deployed. This number will fall far short of the need in the coming weeks and months, in which top federal government officials now estimate that the U.S. will see between 100,000 and 240,000 COVID-19 deaths, even under the restrictive social-distancing measures that are being implemented across the country.

Aren’t U.S. companies stepping in to retrofit their factories for production?

On March 21, the U.S. Department of Health and Human Services issued a request for information to identify manufacturers who have current capability to produce ventilators, or who can quickly modify current capabilities to make them. But production will not happen overnight — equipment needs to be retrofitted, and additional engineers and experts employed.

Ford and General Electric have announced plans to manufacture a combined 50,000 ventilators over the next 100 days, and General Motors is also working to produce the machines. Elon Musk, the CEO of Tesla and SpaceX, also said that his factories have the capability to adapt and help. Last week, the U.K.-based company Dyson announced that it had created, in collaboration with The Technology Partnership, a new ventilator machine of which the U.K.’s National Health Service has already ordered 10,000, and Dyson plans on donating 5,000 of the machines “to the international effort” by this month, 1,000 of which will go to the U.K. (A Dyson spokesperson declined to comment on where the remaining 4,000 machines may go, though they said the company has received requests “from all around the globe.”)

Are there viable alternatives for the full-scale ventilators?

There are other options that can be used as alternatives should hospitals experience a shortage of the full-scale ventilators.

“We have what’s called transport ventilators, which are much smaller and more basic,” Dr. Berman said. Transport ventilators are used when a patient needs to be moved from the ICU to another room in the hospital for other short-term procedures, like, for example, a CAT scan. But these ventilators “only control a few of the many things that can be controlled” in the full-scale units. If the national supply does reach full capacity and there are no more full-scale ventilators available, using transport ventilators to treat COVID-19 patients is “definitely an approach” that should be considered, Dr. Berman said.

In Wednesday’s briefing by state officials, Persichilli reported that New Jersey hospitals have been successfully ventilating COVID-19 patients with anesthesia machines, which are essentially simplified ventilators that cannot perform all of the processes of a full-scale ventilator and are usually used only during surgery.

Dr. Berman also said there are non-invasive methods that are being considered, like “high flow” oxygen therapy, which doesn’t require a tube to be inserted into the patient’s lungs. “Every institution uses them,” he said. “It may be a way to take care of someone’s oxygen needs and stave off mechanical ventilation.”

The use of other non-invasive breathing technologies, like CPAP or BiPAP machines —electronic breathing devices most commonly used in the treatment of sleep apnea and chronic obstructive pulmonary disease — has been circulated in recent media reports, but there is some concern among experts that they may not be effective, and even may increase the risk of infectious transmission. “Almost all patients are requiring ventilators for both oxygenation and ventilation,” Dr. Berman said. “And CPAP and BiPAP cannot do these effectively in this population.”

Could hospitals resort to ‘co-venting’?

Murphy and Cuomo have also mentioned “co-venting,” or connecting two patients to the same ventilator, to stretch resources. Dr. Berman acknowledged this is “being discussed by others” — mostly by doctors in New York City — but said that he wasn’t aware of the status of its application in COVID-19 patients. In Thursday’s briefing with state officials, Persichilli confirmed that, currently, no patients in New Jersey are being co-ventilated.

The practice, however, is rare and risky, given the severely weakened state of patients’ lungs and the unique nature of each case; one provider said it is “nearly impossible” to find two patients who are enough of a “match” to make co-venting a success.

Universities are also jumping in to help. Rutgers University, where Dr. Berman is a professor of medicine, has organized some of its engineers to look at how they can produce basic ventilators. At MIT, a “volunteer team of engineers, physicians, computer scientists, and others,” which calls itself MIT E-Vent, is also currently working on simpler, cheaper alternative that can be deployed for emergency use.

At this stage of the pandemic in New Jersey, and the U.S. in general, Dr. Berman said no one approach should be prioritized over another. “All different groups have to work on this from all different sides,” he said. “It’s a supply and demand race — the manufacturers are trying to ramp up supply, and the national stockpile is trying to increase supply, and the demand is created by the COVID virus. Assessing our needs, and how we can meet those needs, is a part of what we do every day.”

PARSIPPANY — Lake Hiawatha resident Brian Donlin continues to train and fundraise to help to find a cure for Type 1 Diabetes (T1D) with the Juvenile Diabetes Research Foundation (JDRF). Every year, hundreds of cyclists gather in different cities to ride in support of JDRF research at their “Ride to Cure T1D” events. Some are kids and adults with T1D, and some are the friends and family that support them. Brian has known many people in his life that live with T1D, but it really hit home when the diagnosis came to his nephew Zach.

“I remember being pretty young and at my cousin’s house for a party” recalls Brian, “at one point, we didn’t know where my cousin went”. Brian found his cousin in the living room, preparing to give himself a shot of insulin. “I thought it was a little weird but I really didn’t think much more of it at the time. Now watching my nephew live with T1D first hand, I understand what my cousin and my friends have been dealing with for all these years.”

When we last saw Brian, he was just starting his fundraising effort. He is now over a quarter of the way there but still needs more support. Along with personal donations through his JDRF page, click here, and his Facebook fundraiser, he is also seeking potential corporate and business support to help him reach his goal of $3,500. He has been canvasing some of the local businesses with flyers, as well as asking around some of the immediate Lake Hiawatha businesses for help.

He is training for the 100 mile route that takes place in Saratoga Springs, NY on September 12, 2020, along with hundreds of like minded people gathering for a day of fun, camaraderie, and of course, to support the JDRF. You can follow Brian’s progress on his personal site by clicking here and on Strava by clicking here.

In light of the current CoViD-19 health situation, the JDRF has published some great information for those with T1D and how you can keep yourself safe, and how to care for yourself in case you feel sick. While having T1D does not increase your chances of developing the disease, there are some things to stay on top of should you get it. These tips and a wealth of more information can be found by visiting their blog page by clicking here.

Every mile pedaled is a mile closer to a cure. We can’t make it to the finish line without you!