As an early epicenter of the coronavirus outbreak, New Jersey recorded more than 16,000 COVID-19 fatalities, the highest per capita death rate in the country. But the state's tight restrictions on businesses and non-essential activities was credited with slashing transmission rates over the summer and slowing the spread to less than one new case for every newly infected person. 

Now, however, as the local economy continues to reopen—the biggest change being the reintroduction of indoor dining last month—and schools welcome back children for in-person instruction, the Garden State appears to be showing the early signs of a second wave. What started out as isolated outbreaks on college campuses and within the Orthodox Jewish community in Lakewood over the High Holidays, has now snowballed into a statewide crisis, fueled by what state officials say is private indoor gatherings across all of New Jersey’s 21 counties. 

The situation marks a potentially critical juncture in the crisis. New cases in New Jersey have doubled in the last month, with cases now averaging over 1,000 a day for the past week. 

The virus is surging elsewhere in the Northeast too, in states like Rhode Island and Pennsylvania. But within the tri-state region, the caseload in New Jersey, a state closely linked with New York's economy, is cause for alarm. The same is true for Connecticut. Both states have now officially qualified for New York's (and their own) quarantine requirement for out-of-state travelers.

Governor Andrew Cuomo said Tuesday that he doesn’t plan to require residents of either state to quarantine, but has issued an advisory discouraging all nonessential travel into New York

“The question I think that we don't have answers for is whether or not the second wave will be higher than the first one,” said Stephanie Silvera, an epidemiologist and public health professor at Montclair State University. “We're heading into that sort of high risk for community spread designation. We don't have this contained anymore.” 

Governor Phil Murphy last week spoke about the extent of the spread and suggested that residents had grown weary from social distancing and other restrictions.

“It’s pretty clear that this is up and down the state,” Murphy said during a briefing Monday in Trenton. “We had higher ed, we had Lakewood and perhaps we’re still seeing run-offs of those realities but at this point it’s up to all of us to battle through that fatigue.” 

On Wednesday, Murphy cut a press conference short after announcing that he and his wife would go into quarantine after being informed that a staffer had tested positive for COVID-19. It was later reported that a second Murphy staffer had also tested positive.

While state officials said there’s no evidence the bulk of the recent outbreaks are tied to indoor dining or school reopenings, Murphy said on News 12 NJ Monday night that he wasn’t going to increase indoor dining capacities anytime soon, despite recent statements that he would. 

The governor has also urged residents not to travel other than for commuting for work.

To date, there have not been many cases arising in schools. All told, about 60 percent of districts and charter schools are offering at least some in person instruction. The state has so far reported 22 outbreaks in its more than 3,000 school buildings. Still, some districts like Newark, have postponed a return to in-person classes until 2021. 

Silvera, from Montclair State University, said reopening the economy can give the illusion that everything is safe again, even though that’s not necessarily the case. In New Jersey, gyms, movie theaters, indoor dining and schools all reopened the same week. Then the Jewish holidays arrived and cases began to rise. 

“The bigger problem is when you use these pretty significant non-pharmaceutical interventions, the school closures, shutting down businesses and asking people to stay at home, basically shut down the entire state, it's much harder to do that a second time,” she said. “A lot of the will to do that politically and people's compliance with those orders, becomes a little bit harder to do.”

New Jersey continues to test about 20,000 people a day but is testing fewer people per capita when compared to New York or Connecticut, according to data analyzed by John Hopkins University. The state’s positivity rate is around 3.4 percent and state officials say many of the new cases are among young people. 

But people in their 20s and 30s risk passing on the virus to older parents or grandparents, Silvera pointed out. And even though young people are generally less likely to be hospitalized, there’s still a health risk. 

“We keep looking at outcomes as either you survive or you die and there's a lot of outcomes between survival and death,” she said. “There's hospitalizations, there's being in the ICU, there's the taxing of our health care system. And we also know that the death rate from this is not equal across races.”

On Monday, state health commissioner Judy Persichilli cautioned residents to double down on social distancing measures, particularly as the holidays approach. 

“I know we are all tired of COVID-19, it is understandable that we want to go back to normal,” she said. “The trajectory of the next few months will be determined by all of us now and in the next coming weeks. Our behavior will be critical.”