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ED. NOTE: The below replaces an earlier version.
COURT HOUSE – There were over 11,000 new COVID-19 cases confirmed in the last seven days in New Jersey. Hospitalizations reached 1,000 a day for the first time in four months.
The statewide positivity rate, a measure of positive test results to total results, for all tests recorded Oct. 25 was 6.54%, and the statewide transmission rate, as of Oct. 29, is 1.25, meaning every four new cases are likely to infect five additional individuals, advancing the spread.
Gov. Phil Murphy warned that the second wave of the pandemic “is coming now.”
From the time the first COVID-19 case was confirmed in Cape May County March 18, the county managed to diverge from negative state trends concerning the pandemic. Looking at those trends, is that still the case?
New Case Growth
The state is seeing a surge in new cases, with new “hot spots” appearing as soon as others are tamped down. The spike in new cases in Lakewood soon after the Jewish holidays showed signs of abating as a surge made an appearance in the state’s largest city, Newark.
Six counties are reporting 100 new cases per day or more. The average number of new cases per day across the state doubled in October.
In late September and early October, Cape May County’s seven-day rolling average of new cases remained below 50, even adding in the new case count for non-residents.
As of Nov. 1, that number is 142. In the last seven days, the county reported double-digit daily growth in new cases each day.
In terms of new case growth, the county is seeing the same type of surge that is roiling other parts of the state. October ended as the county’s worst month for cumulative new cases since April.
Hospitalizations Climbing
One of the first things that health officials consider when trying to gauge the seriousness of a rising case count is hospitalizations.
For the state, a consideration of COVID-19 hospitalizations does nothing to reduce anxiety levels.
The state’s COVID-19 dashboard places the state’s 71 acute care hospitals into three regions: north, central, and south. In the last week, the southern region, consisting of seven counties, including Cape May County, saw the highest percentage increase in COVID-19-related hospitalizations, a 29% growth.
This compares with 25% in the north and central regions that have basically the same number of hospitalizations at the end of the week that they had at the beginning.
The only one of those 71 hospitals that’s located in Cape May County is Cape Regional Medical Center (CRMC), in Court House. CRMC Oct. 23 reported two COVID-19 patients, one of which required intensive care unit (ICU) placement and the use of a ventilator. As of Oct. 29, CRMC had three COVID-19 patients, with one in intensive care.
For much of the summer and early fall, new cases in the county were centered around younger individuals who do not generally have severe complications from the infection. Whether that trend will hold as new cases mount is unclear.
So far, the rise in hospitalizations in the state is not reflected locally.
Health Metrics Rising
The state positivity rate and transmission rate, along with hospitalization trends, have informed state actions concerning the reopening of the economy. Neither metric is where health officials want it to be.
The positivity rate gives a sense of the circulation of the virus in the community, as well as the level of testing being done.
The Johns Hopkins Bloomberg School of Public Health states, “As a rule of thumb, one threshold for the percent positive being too high is 5%.” New Jersey, after beating back the initial surge of infections in the spring, managed a positivity rate below 3%, from mid-June to late September. The recent rise is something Murphy calls “disturbing.”
The World Health Organization used a 5% or lower positivity threshold as a key metric for the safe reopening of a nation’s economy. The Centers for Disease Control and Prevention recommended 5%, as well.
The state’s three regions display some divergence in positivity. The north, in which most of the hotspots are located, has a positivity rate of 6.76%; central has a rate of 6.85%; and south, which includes Cape May County, has a rate of 5.66%.
The rate of transmission, often referenced as Rt, is a metric that represents the estimated number of new infections that stem from a single case. The goal is to keep the Rt below 1.0, which slows the growth of infection in the community. A rate above 1.0 indicates that the virus is spreading more rapidly. New Jersey’s Rt remained above 1.0 for weeks.
The non-profit COVID Act Now site, built by epidemiologists and health experts, tracks data down to the county level. It reports, as of Nov. 1, Cape May County’s infection rate at 0.92, meaning “on average, each person in Cape May County, New Jersey with COVID is infecting 0.92 other people.” Staying below the state’s higher Rt rate will be crucial in limiting the local community spread of the disease.
School Outbreaks
As September ended, the state announced 11 outbreaks at newly reopened schools, involving 43 individuals. The threshold for an outbreak was two or more positive cases that met the criteria for in-school transmission.
In that first group of schools, Cape May County had three – two public and one private. The state dashboard said that 10 individuals were associated with the three outbreaks.
As of Oct. 29, the number of schools in the state experiencing outbreaks grew to 28, involving 122 individuals. Ocean County has the most outbreaks, with four, and Camden County has the most linked individual cases, with 35.
Since that late September list, no Cape May County schools experienced an outbreak, and the number of involved individuals remains at 10.
Not Immune
With no vaccine yet available, the county is not immune to state trends in the pandemic. However, the county, despite the large influx of people during the summer and the larger than usual population residing in the county, has, so far, managed to stay away from many of the more disturbing trends.
Hospitalizations remain low, key health metrics continue to stay below rising state rates, and school outbreaks appear under control.
A troubling trend is the rapidly growing new case numbers, representing the county’s highest case numbers in months. Equally worrisome is the fact that the new cases are no longer heavily concentrated in the younger population.
A spokesperson for the county Health Department stated that “unlike the summer, when we reported heavy concentration of individuals under 25 years of age,” reports show age ranges for positive tests that are “all over the place.”
An increase in the age range of positive tests could be an omen of rising hospitalizations yet to come. To help bring those numbers back to less dangerous levels, CRMC reemphasized “the five proactive ways to stay healthy and reduce the spread of respiratory illness,” including “to continue to wear a mask, use hand sanitizer or wash hands often, stay socially distanced, avoid social gatherings, especially indoors, and get a flu shot.”
To contact Vince Conti, email vconti@cmcherald.com.
