A long-awaited independent review of New Jersey’s response to the Covid pandemic found the state unprepared for the public health emergency, and that it remains “underprepared” for a new one. The report, released Monday, March 11, was critical of the federal and the state government’s handling of the virus, which killed more than 33,000 New Jerseyans and sickened 3 million.

Gov. Phil Murphy commissioned the $9 million report, calling the pandemic “the greatest crisis our state has ever faced.” It was done by the firm Montgomery McCracken Walker & Rhoads LLP. A principal author of the report is Paul Zoubek, a past New Jersey first assistant attorney general and an assistant U.S. attorney.

The report commends the efforts by state officials to respond to the crisis, saying, “At the state level, heroic actions were taken to respond in good faith to the crisis.” It also says that “no level of effort could overcome an inadequate health-care infrastructure and scarcity of basic needed supplies.”

The report took three paths. The first was an assessment of the state’s level of preparedness when the crisis hit. The second was the way the state responded to the rapid spread of the disease, and the third, a look to the future and the level of preparedness for the next emergency.

Stating that New Jersey is “underprepared” for a new emergency, the report’s authors see it as “a call to action for New Jersey to take the necessary steps to ensure that the state is properly prepared for public health crises.”

The 910-page report plunges a reader into the fear and chaos of the pandemic’s early days. The report acknowledges that New Jersey was “clearly hit harder and faster than many other states.” The state’s population density and its proximity to New York City made it an early target of the virus.

It was in December 2019 that the first reports came from Wuhan, China, about a new respiratory illness. By March 4 New Jersey had its first case confirmed. A public health emergency was declared just days later, on March 9. The first Cape May County case of Covid was on March 19. As of April 13, the county had lost eight individuals to the disease.

The report states that the pandemic “exposed areas where society and its institutions were already weak.” It went on to argue that systematic inequalities built into the health system were present “long before the disease arrived.”

In Cape May County that early penetration of the virus was in locations where the most vulnerable were exposed. In early April the county Department of Health identified 15 residents and 11 staff with confirmed cases at a senior care facility in Lower Township.

The report does not provide the specifics of any county-level impact from the spread of the virus. But those who lived in Cape May County remember the panic buying at stores where toilet paper became an ultra-scarce commodity or where the shelves didn’t contain a single box of spaghetti.

It was a confusing time with conflicting information. The report looks back at the period it covers with informative statistics and graphics but lacks color commentary on the period on the ground in the state’s municipalities.

The challenges at congregate living centers, the closing of schools and day care, the fast-rising unemployment rate and the frequently overwhelmed hospitals were all part of the experience in Cape May County, as was the worry about the fast-approaching summer season.

New Jersey became one of the states that implemented longer shutdowns in an attempt to control the spread of the virus. The report showed the progression from long shutdowns to lost paychecks to changing career paths, and what the report terms as “longer-term impacts on New Jersey’s workforce.”

It was a time of transformation, with remote work models and a boom in home sales outside of urban areas. The impact of the pandemic is still being felt in county real estate values.

While critical of the federal and state handling of the pandemic in many areas, the report credits New Jersey with making “significant systemic improvements” as the crisis unfolded.

“The state, to its credit, took bold and early steps designed to substantially reduce the number of people infected: Shutdowns, quarantines, mask requirements and social distancing were all implemented and resulted in improvements in health outcomes over the course of the pandemic. By the Delta and Omicron wave (from June 2021 to March 2022) New Jersey became one of the states with the lowest death rates,” the report said.

The report noted that school reopenings quickly became a contentious issue in the state. The decision to reopen schools, while meeting state health guidelines, was left to individual school districts. The report concluded: “In hindsight, it is likely that New Jersey students would have benefited from schools opening sooner.”

The report is full of language that acknowledges strengths in the state’s response but ultimately concludes that the state often followed federal guidelines in ways that may have prolonged the harm done by the pandemic in areas of economic and educational losses.

The report broadly covers the state response to the pandemic, including business and school closures, testing capabilities, vaccination protocols, continuity of government, available personal protective equipment and procurement, to name some of the content areas.

A constant theme in the report was that the state’s public health system requires better ongoing investment. It says that “an effective public health capability requires substantial and consistent financial support, including staffing and compensation that attracts people with the necessary knowledge and skills to perform the vital tasks required by the NJDOH and local health departments.”

The recommendations include a need for better emergency plans, along with the necessary training, monitoring and auditing of those plans. It calls for improved resiliency of the long-term-care sector and managing emergencies in congregate settings. The state must improve its collaboration and communications during an emergency response, the report says, including data and technology to support the response.

The report contains 33 specific recommendations.

Ultimately it calls for appropriate resources for the state’s emergency response capability, as well as investment in improving health equity.

As to the future, the report says: “Despite the lessons of the last four years, New Jersey remains underprepared for the next real emergency.” It warns that the state must take preparation seriously.

“New Jersey’s level of preparedness, coordination and innovation during a future emergency will be the result of choices made today. Those choices will determine whether the state is better prepared for the next emergency,” it says.

Murphy said he looks forward to working with the Legislature on the report’s recommendations.

Contact the author, Vince Conti, at vconti@cmcherald.com.