New Jersey hospitals are readying for a winter surge of COVID-19, after the daily average of positive cases increased three-fold since the end of October. COVID patients are occupying more and more capacity at hospitals statewide, and last Friday, state officials confirmed the first case of the omicron variant in a Georgia resident who recently traveled in South Africa.

Many medical centers feel prepared when it comes to supplies, meaning enough ventilators and other essentials are on hand to deal with a potential influx of hospitalizations. But some New Jersey hospitals said they’re hurting because staff are still reeling from the repeated surges of the past two years. Past experience has made the medical workers who remain ready to meet the need, but substitute staff are also being recruited.

“We got through Thanksgiving. We just got through Hanukkah. Now we have to get through Christmas before we’re going to see this go in the opposite direction,” said Dr. John Bonamo, executive vice president of RWJ Barnabas Health. “But we’re very prepared for whatever it comes down to – if in fact we had a surge of significant dimension, we think we’ll be fine.”

In the midst of the holiday season and more gatherings moving indoors from the cold, Bonamo expects this new surge will last well into the new year. Daily positive cases have dramatically risen to 3,800 from a recent low point of 1,200 infections recorded in late October. The statewide positivity rate is approximately 10%, meaning one in 10 tests are coming back with an infection. In the last two weeks, COVID-19 patients in hospital ICUs have risen by a third.

The Barnabas Health system encompasses 11 hospitals as far north as Jersey City and Tom’s River to the south. Rural western counties in northwest Jersey – Warren, Sussex and Hunterdon – are recording the most new hospitalizations per available beds, according to hospital use data collected by the Centers for Disease Control and Prevention.

Lambertville in Hunterdon County, New Jersey

Lambertville in Hunterdon County, New Jersey

Lambertville in Hunterdon County, New Jersey
EQRoy via Shutterstock

Hunterdon Health Center, the sole hospital in Hunterdon County, keeps 178 beds – of which 131 are occupied overall, 22 with COVID-19 patients as of Monday. Of the nearly 2,000 beds in the statewide Barnabas Health system, 200 are currently occupied by coronavirus patients. During the region’s first wave in April 2020, Bonamo said they had about 1,750 patients.

But he said Barnabas is not overly concerned with dealing with another surge because there are now a variety of therapies to keep coronavirus patients out of the hospital, such as monoclonal antibody infusions which can be performed as an outpatient procedure in an emergency room rather than being admitted. Monoclonal antibodies reduce the odds of COVID-19 hospitalization and death by nearly 90% if given early enough.

RWJ Barnabas Health has also been stockpiling equipment and supplies, especially personal protective equipment (PPE). They had so much PPE stockpiled, they recently had to give some away because it was going to expire. They have been making these donations throughout the pandemic – they developed the practice during the shortages of the April 2020 surge.

Staffing Crunch

Staffing has been a challenge for New Jersey medical facilities. Many healthcare professionals are burned out from working through a long pandemic. This nationwide strain has spawned mass quitting in the health care industry, and New Jersey hospitals like Barnabas Health are turning to national staffing agencies to fill the gaps. But those private services provide a sufficient pool of additional workers coming from all over the country – but offer much higher compensations than for typical hospital staff. So, costs are rising.

Vaccines are another reason for why Bonamo feels prepared for a surge – but there is still room for improvement. Unvaccinated coronavirus patients outnumber those with breakthrough infections, 12 to 1, in the Barnabas system. And the vaccinated cases continue to be mild.

About 72% of New Jersey residents are fully vaccinated, but counties lagging behind are already facing a strong rise in hospitalizations. Ocean County has only fully vaccinated about half its population and is averaging about 364 new cases per day. Bonamo said that their facility in Tom’s River, located in that county, is seeing the highest numbers in their system. Southern counties near the coast and ones adjacent to New York City are also seeing the fastest increases in new hospitalizations over the past week.

Overwhelmingly, unvaccinated New Jerseyans face the worst consequences of COVID-19. Statewide, breakthrough cases are about 1% of all coronavirus patients, while their hospitalizations and deaths are at 0.02% and 0.006%, respectively. That means only one in 5,000 of these vaccinated patients experiences a hospitalization, and only about one in 17,000 breakthrough patients dies.

Gov. Phil Murphy urged residents on Wednesday to get vaccinated and take their boosters when eligible. About 34% of the state so far has received their boosters. Murphy also announced the opening of “megasites” to get more people vaccinated.

Vaccination and boosters are the key for getting through the surge, said Bonamo.

“The answer is vaccination, vaccination, vaccination,” said Bonamo. “You're not allowed to drive a car 90 miles an hour because it kills people. You're not allowed to shoot a gun wantonly because it kills people. And you should be vaccinated because if you're not, you can kill people too, and you should not have that right.”